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

Investigation of macrolide, lincosamide and streptogramin B resistance in staphylococcus aureus strains isolated from clinical samples by phenotypical and genotypical methods

Staphylococcus aureus is one of the most common cause of both community and healthcare-associ- Ated infections. As staphylococci have developed resistance to various antibiotics, initially to penicillins then to methicillin and glycopeptides and have the ability to cause epidemics, they continue to be a major problem from past to present. Methicillin resistance gave rise to the use of alternative antibiotics such as macrolides, however worldwide development of macrolide resistance limited the use of these antibiotics. Macrolide resistance occurs either through target site modification (MLSB phenotype, encoded by erm genes), efflux pumps (MS phenotype, encoded by msrA/B genes) or decreased cell wall permeability. The aim of this study was to investigate the MLSB resistance of clinical S.aureus strains with phenotypic and genotypic methods. A total of 404 S.aureus strains isolated from different clinical samples (50% wound, 15% tracheal aspirate and 35% other samples) of inpatients (93.3%) and outpatients (6.7%) were included in the study. Double disc synergy test (D-test) was used for the phenotypical research and PCR was used for the genotypical research of MLSB resistance of isolates. One hundred fifty eight (39.1 %) of the S.aureus isolates were methicillin-resistant (MRSA), and 246 (60.9%) were methicillin-susceptible (MSSA). By the use of D-test, constitutive (cMLSB) and inducible (iMLSB) clindamycin resistance were detected in 19 and 111 isolates, respectively, while five isolates were MS phenotype and 268 isolates were S phenotype (susceptible to erythromycin and clindamycin). The resistance genes of 136 isolates with MLSB resistance phenotype were determined genotypically and among 111 isolates showing iMLSB phenotype ermA gene was found in 81.9% (83 MRSA, 8 MSSA), ermC gene in 10.8% (7 MRSA, 5 MSSA), msrA gene in 10.8% (11 MRSA, 1 MSSA), msrB gene in 1.8% (2 MRSA) and ermB gene in 0.9% (1 MRSA). Among 19 strains with cMLSB phenotype, ermA was found in 57.9% (10 MRSA, 1 MSSA), ermC in 36.8% (6 MRSA, 1 MSSA) and ermB in 15.8% (3 MRSA). Among five strains with MS phenotype, ermA was found in 80% (2 MRSA, 2 MSSA), msrA in 75% (3 MSSA), msrB in 50% (2 MSSA) and ermC in 25% (1 MSSA) of the isolates. ErmA and ermC genes were detected together in 14 isolates, ermA, ermC and msrA genes in one isolate, ermA and msrA genes in 11 isolates, ermA, msrA and msrB genes in three isolates and ermA and ermB genes in three isolates, respectively. In this study, two MRSA isolates with MS phenotype and negative D-test had only ermA gene and among two MSSA strains, erm genes were also determined in addition to msr genes. In our study RAPD-PCR method was used to investigate the clonal similarity, however no dominance of one or a number of clonal type was observed among the isolates in which the resistance genes were identified. In conclusion, the detection of MLSB resistance in S.aureus isolates is likely to influence the selection of antibiotics in the treatment of the infections caused by this bacteria

Prevalence and risk factors for methicillin-resistant Staphylococcus aureus colonization among outpatients undergoing hemodialysis treatment

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) is frequent among hemodialysis patients and lead to increased morbidity and mortality rates. It is known that nasal colonization plays an important role for the development of MRSA infections. The aim of this study was to determine the prevalence and risk factors for MRSA colonization among outpatients undergoing hemodialysis. A total of 466 adult patients (199 female, 267 male; age range: 18-89 years, mean age: 55.8 ± 15.1 years) who were under hemodialysis between September-December 2008 in different health centers at Pamukkale/ Denizli region, Turkey, were included in the study. Swab samples obtained from anterior nares of patients were cultivated on sheep-blood agar and mannitol-salt agar media. The isolates were identified by conventional bacteriological methods. S.aureus strains were isolated from 204 (43.8%) patients and 34 (16.7%) were found methicillin-resistant. Thus the rate of MRSA colonization in hemodialysis patients was detected as 7.3% (34/466). All of the MRSA strains'were found susceptible to vancomycin, linezolid and tigecycline, while the resistance rates for the other antimicrobial agents were as follows: 70.6% to azithromycin and claritromycin; 64.7% to erythromycin; %58.8 to clindamycin, gentamicin and trimethoprim-sulfamethoxazole; 55.9% to ciprofloxacin; 44.1% to tetracycline and rifampin; 5.9% to chloramphenicol. Inducible clindamycin resistance in MRSA isolates was %23.5 (8/34), and multidrug resistance rate was 76.5% (26/34). Multivariate analysis revealed that the history of previous hospitalization within a year [odds ratio (OR), 3.426; 95% confidence interval (CI), 1.595-7.361, p= 0.002] and the presence of chronic obstructive lung disease (OR, 5.181; 95% CI, 1.612-16.648, p= 0.006) were independent risk factors for MRSA colonization in this population. A better understanding of the prevalence and risk factors for nasal MRSA colonization among hemodialysis population may hold significant implications for both the treatment strategies and prevention of MRSA infections to establish appropriate infection control measures

Investigation of Beta-Lactamases in carbapenem-resistant A. Baumannii isolates

Objectives: To investigate the prevalence of PER-1, PER-2, GES, IMP-1, VIM-2, OXA-23, and OXA-24 type beta-lactamases in carbapenem-resistant Acinetobacter baumannii isolates, in view of the fact that Beta-lactamase production is the most important mechanism of acquired beta-lactam resistance in Gram-negative pathogens. Design: Experimental study Setting: Department of Medical Microbiology, School of Medicine, Pamukkale University, Denizli, Turkey Subjects: From January 2009 to December 2009, a total of 98 carbapenem-resistant A. baumannii bacteria were isolated from patients. Intervention: In-house PCR was performed for the detection of PER-1, PER-2, GES, IMP-1, VIM-2, OXA-23, and OXA-24 beta-lactamase genes in those clinical carbapenem-resistant A. baumannii isolates. Main Outcome Measure: Prevalence rate of beta-lactamase genes in carbapenem-resistant A. baumannii isolates Results: GES beta-lactamase was found in 59 isolates (60.20%). PER-1 was found in eight isolates (8.16%). IMP-1 was found in five isolates (5.10%). OXA-24 was detected in two isolates (2.04%). No isolate possessed VIM-2, PER-2, or OXA-23 beta-lactamase genes. Conclusion: This study indicates that the GES type beta-lactamases are the most prevalent among carbapenem-resistant A. baumannii isolates in our hospital. Screening for beta-lactamases and strict infection control for these isolates will help prevent further spread of resistance. © 2015, kuwait Medical Association. All rights reserved

Investigation of hepatitis G virus prevalence in hemodialysis patients and blood donors in Denizli, Turkey

Bu çalışmanın amacı, hemodiyaliz hastalan ile kan donörlerinde hepatit C virus (GBV-C/HGV) pre-valansının araştırılmasıdır. Şubat-Aralık 2006 tarihleri arasında Denizli'de gerçekleştirilen çalışmaya, hemodiyaliz uygulanan 100 hasta (yaş ortalaması: 56.8 ± 13.3 yıl; 46'sı kadın) ile gönüllü 100 kan donö-rü (yaş ortalaması: 31.3 ± 8.1 yıl; 8'i kadın) dahil edilmiş; GBV-C/HGV RNA varlığı ters transkriptaz PCR yöntemi ile GBV-C/HGV anti-E2 antikor varlığı ise ticari enzim immün yöntemi (Diagnostic Automation, INC®) ile araştırılmıştır. Hemodiyaliz hastalarının 14 (%14)'ünde ve kan donörlerinin 2 (%2)'sinde GBV-C/HGV RNA pozitif olarak saptanmış; gruplar arasındaki fark istatistiksel olarak anlamlı bulunmuştur (p< 0.05). GBV-C/HGV anti-E2 antikor varlığı ise hemodiyaliz hastalarının 1 (%1)'inde ve kan donörlerinin 3 (%3)'ünde tespit edilmiştir. Antikor varlığı saptanan bir hastada aynı zamanda viral RNA pozitifliği de mevcuttur. Gruplar arasında antikor pozitiflik oranları açısından anlamlı bir fark bulunmamıştır. GBV-C/HGV prevalansı hemodiyaliz hastalarında %14, kan donörlerinde %5 olarak belirlenmiş ve bu oran hemodiyaliz hastalarında, kan donörlerine göre anlamlı olarak yüksek saptanmıştır (p< 0.05). GBV-C/HGV pozitif ve negatif hemodiyaliz hastaları arasında, hemodiyaliz süresi, serum alanin aminotrans-feraz (ALT) düzeyleri, yaş ve cinsiyet açısından anlamlı farklılık tespit edilmemiştir. Sonuç olarak; kan do-nörleri ile karşılaştırıldığında, parenteral bulaş açısından riskli bir grup olması nedeniyle, hemodiyaliz hastalarında GBV-C/HGV viremi oranı ve prevalansı anlamlı olarak yüksektir. Ancak hemodiyaliz ünitelerinde hijyen şartlarına uyumun artışı, gereksiz kan transfüzyonlarından kaçınılması, eritropoetin kullanımı artışı gibi yöntemlerle bölgemizde de GBV-C/HGV prevalansı ve GBV-C/HGV ile hepatit C virus birlikteliği düşmektedir.This study focuses on the prevalence of hepatitis G virus (GBV-C/HGV) in hemodialysis patients and blood donors in Denizli (located at Aegean region of Turkey). A total of 100 patients (mean age: 56.8 +/- 13.3 years; 46 female) receiving hemodialysis and 100 blood donors (mean age: 31.3 +/- 8.1 years; 8 female) were included in the study. The presence of GBV-C/HGV RNA was determined in all patients by reverse transcriptase-PCR and the presence of GBV-C/HGV anti-E2 antibodies was determined by a commercial enzyme immunoassay (Diagnostic Automation, INC). Viral RNA positivity was determined in 14 (14%) of the hemodialysis patients and 2 (2%) of the blood donors, the difference being statistically significant (p < 0.05). GBV-C/HGV anti-E2 antibodies were detected in 1 (1%) of the hemodialysis patients and 3 (3%) of the blood donors. Anti-E2 positive patient also revealed positive result for viral RNA. There was no statistically significant difference between the two groups in terms of anti-E2 positivity. The prevalence of GBV-C/HGV was 14% in hemodialysis patients and 5% in blood donors (p < 0.05). There was no significant difference in terms of duration of hemodialysis, serum ALT levels, age or gender between GBV-C/HGV positive and negative hemodialysis patients. In conclusion, since hemodialysis patients are at an increased risk of parenteral transmission, they have significantly higher GBV-C/HGV viremia rates and prevalence when compared to blood donors. However, the prevalence of GBV-C/HGV and coexistence between GBV-C/HGV and hepatitis C virus have been decreasing in our region owing to increased hygienic precautions in hemodialysis units, avoidance of unnecessary blood transfusions and more widespread use of erythropoietin

The effects of treatment with Saccharomyces boulardii on bacterial translocation in rats with obstructive jaundice

Aim: The aim of this study was to evaluate the effects of the treatment with Saccharomyces boluardii which is widely used as a probiotic on bacterial translocation (BT) in biliary obstruction. Material and Methods: For this purpose, thirty male albino rats were, divided in 3 groups: Group 1. Sham-operated (n = 10), Group 2. Common bile duct (CBD)-ligated (n = 10), Group 3. Common bile duct-ligated and treated with Saccharomyces boluardii (n=10). In group 3, rats were treated with Saccharomyces holuardii (1mg/g body weight/clay) that was given by orogastric feeding tube for five days after CBD ligation. In Group 1 and Group 2, rats were given same amounts of sterile saline as placebo. After 6 days of surgery, all rats were sacrificed. Cultures of the mesenteric lymph nodes (MLNs), liver, spleen, blood and cccal contents were obtained. Results: The incidence of bacterial translocation was found as 10 % in Group 1,70 % in Group 2 and, 30 % in Group 3. Increase in the incidence of bacterial translocation was statistically significant in Group 2 compared with Group 1 (p0.05), a significant increase was not found compared with Group 1. On the other hand, total bacterial count of cecal flora was found as significantly increased in Group 2 when compared with Group 1 (p0.05). Conclusion: These data suggested that biliary obstruction promotes and enhances the BT. Saccharomyces boulardii relatively protected the intestinal ecological equilibrium. The administration of S. boulardii may decrease the incidence of BT in obstructive jaundice

Pemfigus etiyopatogezinde coxsackle virüsün olası rolünün araştırılması

Başlangıç seviyesi projesiPemfigus desmozomal proteinlere karşı oluşan antikorlara bağlı gelişen otoimmun büllöz hastalık grubudur. Etiyolojisi tam olarak aydınlanmamış olmakla birlikte viral enfeksiyonlar da suçlanmaktadır. Sunulan çalışmada Pamukkale Üniversitesi Tıp Fakültesi Hastanesi Dermatoloji polikliniğine başvuran pemfigus tamlı hastalarda, histopatolojik olarak akantolizin izlendiği başka bir hastalık olan el- ayak-ağız hastalığı etkeni Coxsackie virüslerin, hastalığın seyri sırasında artmış olduğu gösterilmiş çeşitli kemokin ve sitokinler üzerine sahip olduğu arttırıcı etkilerinden yola çıkarak, perilezyonel deri biyopsi materyalinde ve kanda Coxsackie virus varlığı araştırılmıştır. Bu çalışma ile Pemfigus tamlı hastalar ile sağlıklı kontrol olguları Coxsackie virus IgM ve IgG seroprevalansı açısından karşılaştırılmıştır. Bu araştırma Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Birimi tarafından 2009BSP016 No.lu proje olarak desteklenmiştir

The investigation of the possible relationship between Coxsackie viruses and pemphigus

Background: Pemphigus is a group of autoimmune bullous diseases on which the etiopathogenesis of several viruses has been blamed. Coxsackie viruses (CVs) are the causative agents of hand, foot, and mouth disease, and herpangina, which have been strongly associated with several autoimmune diseases. The onset of pemphigus after CV infection and cephalosporin use has been reported. Objective: To detect the presence of CV in patients with pemphigus. Materials and methods: Reverse transcriptase-polymerase chain reaction analysis for CV RNA sequences and immunohistochemical staining for the CV and adenovirus receptor expression were performed on patient skin samples. CV-IgM and -IgG serum levels were analyzed. Results: Thirty-two patients and 40 controls were investigated. Neither the CV and adenovirus receptor expression nor CV RNA sequences was established in the skin samples of patients. The ratio of CV-IgG positivity was higher in patients (12.5%) than in the controls (5%; P > 0.05). Conclusion: Our preliminary results indicate that the viral genome of CV does not become persistent in the skin. Further studies with a larger number of cases are needed to clarify the place of CVs in the etiopathogenesis of pemphigus. © 2013 The International Society of Dermatology