External decontamination of wild leeches with hypochloric acid

BACKGROUND: Medicinal leech, Hirudo medicinalis, has been used in plastic and reconstructive surgery, to relieve venous congestion and to improve the microrevascularization of flaps. In many countries, wild leeches are still provided from local markets and utilised with antibiotic prophylaxies. In this research, results of identification of bacteria in the transport fluid is reported, oral and intestinal floras and the antibiograms of the identified microorganisms are investigated. Also, to avoid possible infections, the ability of hypochloric acid, a disinfectant, to suppress the relevant microorganisms without changing the life style and behavior of leeches in terms of sucking function, is investigated. METHODS: Bacterial identifications and antibiograms of oral and intestinal flora and transport medium were performed for 10 leeches. The optimum concentration of hypochloric acid which eliminated microorganisms without affecting the viability and sucking function of the leeches were determined by dilution of hypochloric acid to 100, 50, 25, 12.5, 6.25 ppm concentrations in different groups of 25 leeches. Finally, 20 leeches were applied atraumatically to the bleeding areas of rats, the duration of suction was determined and compared statistically between the leeches treated and not treated with hypochloric acid solution. RESULTS: Aeromonas hydrophilia was the most commonly identified microorganism and found to be resistant to first generation cephalosporins, frequently used in prophylaxis at surgical wards. In the next stages of the study, the leeches were subjected to a series of diluted hypochloric acid solutions. Although disinfection of the transport material and suppression of the oral flora of hirudo medicinalis were successful in 100, 50, 25, 12.5, 6.25 ppm concentrations; 12.5 ppm solution was the greatest concentration in which hirudo medicinalis could survive and sucking function was not affected significantly. CONCLUSIONS: External decontamination of wild leeches with 12.5 ppm hypochloric acid enables bacterial suppression without causing negative effects on leech sucking function and life

Live Cell Imaging of Bone Marrow Stromal Cells on Nano-pitted and Polished Titanium Surfaces: A Micro-Incubator in vitro Approach

Current orthopedic implants are not conducive for optimal integration of the biomaterial with newly-formed tissue (osseointegration) inside a patient’s body. In this study, medical-rade Ti-6Al-4V was used as a substrate due to its biocompatibility and ability to facilitate cellular adhesion and proliferation. Live cell imaging was conducted on bone marrow stromal cells, genetically modified to express the green fluorescent protein (GFP), from the 24-96 hours growth period, with the first 24 hours of growth being held inside a lab-scale incubator. Periodic images were recorded on nanopitted anodized and polished Ti-6Al-4V substrates to study how substratestiffness influences adhesion and proliferation. Collected images were analyzed for mitosis, adhesion, and filopodia-stretchability using ImageJ, an image processing program. Images were enhanced in order to perform cell counts at 24, 48, 72, and 96 hours of growth. Continuous recordings were produced to account for the number of mitosis occurrences and cellular migration on each of the substrates. Based on the conducted experiments, it appears that polished Ti-6Al-4V has a higher cell adherence than “nanopitted” anodized surface and an improved rate of proliferation which may be because the cells once adhered on the nano-pitted surface have less ability to detach in-order to undergo mitosis.https://engagedscholarship.csuohio.edu/u_poster_2014/1004/thumbnail.jp

A Prospective Study of Etiology of Childhood Acute Bacterial Meningitis, Turkey

Vaccines to prevent bacterial meningitis in this region must provide reliable protection against serogroup W-135

TYPING OF EXTENDED-SPECTRUM BETA-LACTAMASES IN ESCHERICHIA COLI AND KLEBSIELLA SPP. STRAINS AND ANALYSIS OF PLASMID PROFILES

Bu çalışmada, İstanbul Tıp Fakültesi Hastanesinin farklı ünitelerinde (yoğun bakım, hematoloji, onkoloji, yenidoğan, transplantasyon, çocuk cerrahisi) yatan hastaların çeşitli klinik örneklerinden (idrar, kan, trakeal aspirat, apse, boğaz, dren/kateter ucu, plevra/periton sıvısı, beyin omurilik sıvısı, göz) izole edilen genişlemiş spektrumlu beta-laktamaz (GSBL) üreten 12 Escherichia coli ve 32 Klebsiella spp. (28 K.pneumoniae, 4 K.oxytoca) suşlarındaki beta-laktamaz enzimlerinin araştırılması ve tiplendirilmesi amaçlanmıştır. NCCLS (CLSI) önerilerine göre disk difüzyon yöntemi ile yapılan antimikrobiyal duyarlılık testlerinde imipeneme ve meropeneme dirençli suşa rastlanmamıştır. Agar dilüsyon yöntemiyle hem E.coli, hem de Klebsiella suşlarında sefotaksim için MİK50 ve MİK90 sırasıyla 16 μg/ml ve 64 μg/ml olarak bulunmuştur. GSBL varlığı, disk difüzyon testinde klavulanik asit ve 3. kuşak sefalosporinler arasındaki sinerji ile gösterilmiştir. Suşların tümü, çift disk sinerji ve E-test ile GSBL fenotipi göstermiştir. Yapılan izoelektrik fokuslama sonuçlarına göre, suşlarda, pI: 5.4-9.0 arasında 1-4 adet beta-laktamaz bulunmuştur. TEM, SHV ve CTX-M genlerine özgül primerler kullanılarak yapılan polimeraz zincir reaksiyonu (PCR) sonuçlarına göre K.pneumoniae ve E.coli suşlarında TEM, SHV ve CTX-M beta-laktamazların oranı sırasıyla %64.3, %92.9, %64.3 ve %66.7, %25, %83.3 olarak bulunmuştur. ERIC-2 primeri kullanılarak yapılan RAPD (Randomly Amplified Polymorphic DNA)-PCR ile suşların 170-1500 bp arasında bantlara sahip olduğu görülmüş ve K.pneumoniae’da 10, K.oxytoca’da 3 ve E.coli’de 6 grup belirlenmiştir. Konjugasyon ile 44 suşun 31 (%70.4)’inde antibiyotik direnci alıcı suşa aktarılabilmiştir. Plazmid profil analizine göre transkonjugatların 20 (%64.5)’sinin tek bir plazmide (> 48 kb), 11 (%35.5)’inin ise birden fazla plazmide (10- 100 kb) sahip olduğu saptanmıştır. Bu sonuçlar, hastanemizde izole edilen E.coli ve Klebsiella suşları arasında CTX-M beta-laktamazın, yüksek oranda olduğunu ve hızla yayıldığını göstermektedir

Susceptibility of clinical methicillin-resistant Staphylococci isolates to new antibiotics

Background: The treatment of methicillin-resistant staphylococcal infections has been a growing problem both in and out of hospitals for the past 30 years. Therefore, there is a need for other antibiotics as an alternative to glycopeptides in the treatment of methicillin-resistant staphylococcal infections. This study investigated the in vitro susceptibility of 49 methicillin-resistant Staphylococcus aureus (MRSA) and 59 methicillin-resistant coagulase negative staphylococci (MRCNS) clinical isolates to daptomiycin, telithromycin, tigecyclin, quinupristin/dalfopristin, and linezolid

Susceptibility of clinical methicillin-resistant Staphylococci isolates to new antibiotics

Background: The treatment of methicillin-resistant staphylococcal infections has been a growing problem both in and out of hospitals for the past 30 years. Therefore, there is a need for other antibiotics as an alternative to glycopeptides in the treatment of methicillin-resistant staphylococcal infections. This study investigated the in vitro susceptibility of 49 methicillin-resistant Staphylococcus aureus (MRSA) and 59 methicillin-resistant coagulase negative staphylococci (MRCNS) clinical isolates to daptomiycin, telithromycin, tigecyclin, quinupristin/dalfopristin, and linezolid

Serotype Distribution and Antibiotic Resistance of Streptococcus pneumoniae Strains Isolated from the Adult Patients in a Turkish University Hospital

Infections caused by Streptococcus pneumoniae are the most important cause of morbidity and mortality worldwide. S. pneumoniae is the most common cause of community-acquired pneumonia, especially in adults. Invasive pneumococcal disease can usually occur in the elderly, children and immunocompromised individuals. Usage of the vaccines for the protection against S. pneumoniae infections, is an effective method to reduce the burden of disease in both children and adults. Serotypes frequently isolated from purified capsular polysaccharides of S. pneumoniae are used in polyvalent vaccines. Significant differences are observed between countries and regions in serotypes and antibiotic resistance of S. pneumoniae strains. For this reason, each country and region should determine their own serotypes and antibiotic resistance. The aim of this study was to determine serotype distribution, antibiotic resistance and vaccine coverage rates in S. pneumoniae strains isolated from invasive and non-invasive samples of adult patients in our hospital. A total of 100 S. pneumoniae isolates from invasive and non-invasive samples of adult patients between March 2007 and August 2014 were used in this study. S. pneumoniae strains were identified by conventional methods. Serogrouping was performed with the latex particle agglutination and serotyping was made with the conventional Quellung reaction using a commercial type-spesific antisera (Statens Serum Institute, Copenhagen, Denmark). Antibiotic susceptibility testing for penicillin G, cefotaxime and erythromycin was performed by gradient test and evaluated according to the breakpoints of Clinical and Laboratory Standards Institute (CLSI). Sixty four percent of of the S. pneumoniae strains were isolated from non-invasive and 36% were isolated from invasive samples. Serotype 3 (20%), 19F (9%), 8 (7%), 14 (7%), 23F (6%), 6A (6%) were most common determined serotypes among all strains. Among S. pneumoniae strains isolated from invasive samples serotype 3 (22%), 14 (14%), 1 (8%) and in S. pneumoniae strains isolated from non-invasive samples 3 (19%), 19F (11%), 6A (9%), 23F (8%) were the most common serotypes. Among all isolates 2% penicillin and 3% cefotaxime intermediate resistance were detected. Erythromycin resistance was detected in 25% of invasive, 37% of non-invasive strains and a total of 33% in all of the isolates. Vaccine coverage rates were found to be 68% for PCV13 and 78% for PPV23 among all isolates. In our study penicillin resistance was lower compared with the other similar studies in the world, but resistance against erythromycin was almost similar. This study is important to show that serotype 3 predominated in serious pneumococcal infections in the adult population of our hospital. For this reason, administration of routine pneumococcal vaccination program in adults and especially in the elderly is recommended. In conclusion, it is important to know the serotype distribution and antibiotic resistance of S. pneumoniae to monitor the empirical treatment in serious pneumococcal infections

Investigation of Seropositivity of Bordetella pertussis in Adults in A University Hospital

Whooping cough is a vaccine-preventable infectious diseases caused by Bordetella pertussis/parapertussis. Despite of routine immunization programs in the world, pertussis still remains endemic. Recently unvaccinated or partially immunized infants have infected with this pathogen and also increase of incidence was observed in adolescents and adults. The source of pertussis in newborns are attributed to household, especially due to the family members. Theaim of this study was to determine B.pertussis IgG antibody positivity by ELISA method in adults. Eighty-four of the total study population (39.6%) were anti-pertussis IgG positive, 128 (60.4%) were negative. The samples included in the study (n=212) were divided into three groups according to ages: 19-35 years (Group 1, n=61), 36-50 years (Group 2, n=58), 51-65 years (Group 3, n=93). Anti-pertussis IgG antibody positivity was 26.2% (n=22) in Group 1, 26.2% (n=22) in Group 2 and 47.6% (n=40) in Group 3. According to the anti-pertussis IgG positivity results, no significant difference was observed between genders. The results were obtained as absorbance values by ELISA test, then transformed into semi-quantitative values as NovaTec Test Unit (NTU). NTU positive values were between 11.01-39.4. Ninety four percent of NTU values were in the range of 11.01 to 28.01 and 6% were between 28.01 to 39.4. It was observed that seropositivity rates peaked at ages of 27, 55 and 65. The highest NTU values were observed in the age of 32 in females and in the age of 24 in males. Relatively, low seropositivity values (NT=15-20) were observed in both females and males to the age of 45 in Group 2. However a slight increase was observed in females after the age of 45. An increase (NTU >= 20) was determined in the age of 49 in males. The seropositivity rates were generally low (NT = 30) were observed in 55 and 65 years of age in males in this group. The highest seropositivity (NTI >= 30) were in 55 and 65 years of age (NTI >= 30) in males and 27 years of age (NTU >= 30) in females while in 36-50 age range, it was relatively low (NTI <= 20). Routine pertussis vaccination program is not yet implemented for adults in our country. However, the causes more clearly demonstrate the need for adult pertussis vaccination since adults may be incompletely vaccinated or not vaccinated in the childhood, current vaccinations are not available in the childhood of adults, adults become more susceptible to infections as the age increases, life expectancy increases and the likelihood of encountering infections, and childhood vaccination antibodies diminish over time. According to the results of this study, a single dose of pertussis vaccine is recommended to implement for adults in our country

Investigation of Seropositivity of Bordetella pertussis in Adults in A University Hospital

Whooping cough is a vaccine-preventable infectious diseases caused by Bordetella pertussis/parapertussis. Despite of routine immunization programs in the world, pertussis still remains endemic. Recently unvaccinated or partially immunized infants have infected with this pathogen and also increase of incidence was observed in adolescents and adults. The source of pertussis in newborns are attributed to household, especially due to the family members. Theaim of this study was to determine B.pertussis IgG antibody positivity by ELISA method in adults. Eighty-four of the total study population (39.6%) were anti-pertussis IgG positive, 128 (60.4%) were negative. The samples included in the study (n=212) were divided into three groups according to ages: 19-35 years (Group 1, n=61), 36-50 years (Group 2, n=58), 51-65 years (Group 3, n=93). Anti-pertussis IgG antibody positivity was 26.2% (n=22) in Group 1, 26.2% (n=22) in Group 2 and 47.6% (n=40) in Group 3. According to the anti-pertussis IgG positivity results, no significant difference was observed between genders. The results were obtained as absorbance values by ELISA test, then transformed into semi-quantitative values as NovaTec Test Unit (NTU). NTU positive values were between 11.01-39.4. Ninety four percent of NTU values were in the range of 11.01 to 28.01 and 6% were between 28.01 to 39.4. It was observed that seropositivity rates peaked at ages of 27, 55 and 65. The highest NTU values were observed in the age of 32 in females and in the age of 24 in males. Relatively, low seropositivity values (NT=15-20) were observed in both females and males to the age of 45 in Group 2. However a slight increase was observed in females after the age of 45. An increase (NTU >= 20) was determined in the age of 49 in males. The seropositivity rates were generally low (NT = 30) were observed in 55 and 65 years of age in males in this group. The highest seropositivity (NTI >= 30) were in 55 and 65 years of age (NTI >= 30) in males and 27 years of age (NTU >= 30) in females while in 36-50 age range, it was relatively low (NTI <= 20). Routine pertussis vaccination program is not yet implemented for adults in our country. However, the causes more clearly demonstrate the need for adult pertussis vaccination since adults may be incompletely vaccinated or not vaccinated in the childhood, current vaccinations are not available in the childhood of adults, adults become more susceptible to infections as the age increases, life expectancy increases and the likelihood of encountering infections, and childhood vaccination antibodies diminish over time. According to the results of this study, a single dose of pertussis vaccine is recommended to implement for adults in our country

Sealing capability and marginal fit of titanium versus zirconia abutments with different connection designs

PURPOSE. Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS. A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with 0.7 mu L of polymicrobial culture (P gingiyalis, T forsythia, T denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (alpha=.05). RESULTS. Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in pm) of the groups were in the range of 2.7-4.0 (IC-Zr), 1.8-5.3 (IC-Ti), 6.5-17.1 (IT-Zr), 5.4-12.0 (IT-Ti), 16.8-22.7 (EH-Zr), and 10.3-15.4 (EH-Ti). CONCLUSION. The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design