Determination of Susceptibility to Tigecycline in Methicillin-Resistant Staphylococcus aureus Isolates

Amaç Metisiline dirençli Staphylococcus aureus (MRSA), burun ve deride kolonize olabilen, selülit, impetigo ve abseye yol açabilen, toplum ve hastane kaynaklı ciddi enfeksiyonlara neden olabilen önemli bir patojendir. Direnç sorunu nedeniyle MRSA enfeksiyonlarında tedavide güçlüklerle karşılaşılmaktadır. Araştırmacılar tedavi seçeneklerinin sınırlı kalmasından dolayı alternatif arayışlarına devam etmektedir. Bir glisilsiklin türevi olan tigesiklin (GAR-936) son yıllarda kullanıma giren bir ajandır. Bu çalışmada Abant İzzet Baysal Üniversitesi Tıp Fakültesi mikrobiyoloji laboratuvarında çeşitli klinik örneklerden elde edilen MRSA izolatlarında tigesikline duyarlılık oranının in vitro olarak araştırılması amaçlanmıştır. Materyal ve Metod Toplam 100 MRSA izolatına için tigesiklin minimum inhibitör konsantrasyon (MİK) değerleri sıvı mikrodilüsyon yöntemiyle belirlenmiştir. Bulgular Tigesiklinin izolatlara karşı MİK değerleri 0,0625-4 µg/ml aralığında bulunmuş, buna göre izolatların 91’i (%91) tigesikline duyarlı, dokuzu (%9) ise dirençli bulunmuştur. MİK50 değeri 0,25 µg/ml, MİK90 değeri ise 0,5 µg/ml olarak saptanmıştır. Sonuç Ülkemizde yapılmış diğer çalışmalardakinden daha yüksek bir direnç oranı bulunmuş olmasına rağmen, çalışmamızda elde edilen bulgular, hastanemizde MRSA nedenli enfeksiyonların tedavisinde tigesiklinin halen uygun bir alternatif olduğunu göstermektedir.Aim Methicillin-resistant Staphylococcus aureus (MRSA) is an emergent pathogen which can colonize in nose and on the skin; lead sellulitis, impetigo and abscess and which can cause community and hospital-acquired serious infections. Treatment of MRSA infection encounters difficulties due to the resistance. Researchers continue to search for an alternative due to the limited treatment options. Tigecycline (GAR-936), a derivative of glycylcycline, is an agent accepted for the usage for treatment in recent years. In this study, it was aimed to investigate the in vitro susceptibility rate of MRSA strains isolated from various clinical specimens in microbiology laboratory of Abant Izzet Baysal University Faculty of Medicine. Material and Methods Minimum inhibitory concentration (MIC) of tigecycline were detemined with broth microdilution method for a total of 100 MRSA isolates. Results MIC values of tigecycline to the isolates were found between a range of 0.0625-4 µg/ml; according to this, 91 (91%) of the isolates were determined as susceptible and 3 (3%) were found as intermediate to tigecycline. The MIC50 value was found 0.25 µg/ml and MIC90 was 0.5 µg/ml. Conclusion Despite the higher resistance rate to tigecycline in comparison to data obtained from other studies of our country, the findings of our study shows that tigecycline is still an appropriate alternative in treatment of infections caused by MRSA in our hospital

Prevalence of anti-HDV and HDAg in patients with chronic hepatitis B

Objective: In this study, it is aimed to evaluate the correlationof the test results of anti-HDV and HDAg in patientswith chronic HBV infection and to collect data concerningHDV epidemiology.Materials and methods: Anti-HDV and HDAg test resultsand demographic data of the patients with chronic HBVinfection by gastroenterology and infectious diseasesin Agri State Hospital between January 2009-May 2012were analyzed retrospectively. HBsAg and Anti-HBc IgMtests were performed with macroelisa, anti-HDV andHDAg were tested with microelisa.Results: A total of 787 patients constituting 315(40.0%)females and 472(60.0%) males were included in thestudy. All the patients were HBsAg positive and Anti-HBcIgM negative. Of these patients, 55(7.0%) cases wereonly anti-HDV positive; 19(2.4%) were only HDAg positiveand two cases were both anti-HDV and HDAg positive.A total of 76(9.7%) patients had positive findings ofHDV infection. The mean age of HDV-positive patientswas 42.1±15.2 (11-77 years); of these 36(47.4) were femaleand 40(52.6) were male.Conclusion: In patients with chronic viral hepatitis, HDVinfection still remains significant. In our study HDV infectionrate was detected as 9.7%. Although this rate is lowerthan the earlier reports of the same region, it is above thenational average.Key words: HDV, HDAg, delta antigen, anti-HDV, chronic hepatitis B, pai

Human rights violations in east Turkestan and the problem of the conformity of the actual situation with the Chinese constitution

Bu tezde, Çin Halk Cumhuriyeti tarafından Sincan Uygur Özerk Bölgesi olarak tanımlanan Doğu Türkistan'da, Çin tarafından gerçekleştirilen insan hakları ihlallerini ve bu ihlallere karşı Çin Anayasasının ne gibi tedbirler aldığı incelenerek, bölgede yaşanan çelişki durumu açıklanmaya çalışılmıştır. Birinci bölümde, "azınlık" kavramı, uluslararası sözleşmeler bağlamında Çin Halk Cumhuriyeti'nin durumu ve ülkede yaşayan azınlık milletlerin tanımlanması ve azınlıkların fiili durumu incelenerek açıklanmıştır. Tezimizin ikinci bölümünde, "insan hakları" kavramı; uluslararası sözleşmeler, hukuki metinler ve Çin Halk Cumhuriyeti Anayasası ışığında incelenmiştir. Yapılan araştırmalar sonucunda elde edilen bulgular ışığında, Doğu Türkistan'da yaşanan hak ihlalleri yine uluslararası sözleşmeler ve Çin Halk Cumhuriyeti Anayasası uyarınca değerlendirildi ve gerekli örneklendirmeler yapılmaya gayret edildi. Bu bağlamda "Birleşmiş Milletler İnsan Hakları Evrensel Bildirisi, Birleşmiş Milletler Siyasi ve Medeni Haklar Uluslararası Sözleşmesi ve Birleşmiş Milletler Ekonomik Sosyal ve Kültürel Haklar Uluslararası Sözleşmesi" baz alınarak yaşanan hak ihlalleri kategorilere ayrıldı ve detaylı olarak izah edildi. Netice itibariyle; Çin Halk Cumhuriyeti'nin Doğu Türkistan'da ne sebeple insan hakları ihlaline varacak uygulamalarda bulunduğu açıklandı. Sorunun ortadan kaldırılabilmesi için gerekli önlemlerin neler olabileceği ifade edilmeye gayret edildi.In his master's study titled "Human Rights Violations in East Turkestan and the Problem of the Confirmity of the Actual Situation with the Chinese Constitution", the human rights violations committed by China in East Turkestan, which is defined as the Xinjiang Uyghur Autonomous Region by the People's Republic of China, and what the Chinese Constitution does against these violations. It has been tried to explain the situation of contradiction in the region by examining the measures taken like this. In the first chapter, the concept of "minority" is explained by examining the situation of the People's Republic of China in the context of international conventions, the definition of minority nations living in the country and the actual situation of minorities. In the second part of our thesis, the concept of "human rights"; examined in the light of international conventions, legal texts and the Constitution of the People's Republic of China. In the light of the findings obtained as a result of the researches, the rights violations in East Turkestan were evaluated in accordance with international conventions and the Constitution of the People's Republic of China, and necessary examples were tried to be made. In this context, violations of rights were categorized and explained in detail based on the "United Nations Universal Declaration of Human Rights, the United Nations International Covenant on Political and Civil Rights and the United Nations International Covenant on Economic, Social and Cultural Rights". As for the conclusion part of our study; It has been explained why the People's Republic of China in East Turkestan carries out practices that will result in human rights violations. The thesis was concluded by stating what measures could be taken to eliminate the problem

Kronik hepatit B enfeksiyonlu hastalarda Anti-HDV ve HDAg prevalansı

Amaç: Bu çalışmada, Ağrı ilinde kronik hepatit B enfeksiyonu tanısıyla takip edilen hastaların anti-HDV ve HDAg test sonuçlarının korelasyonunun irdelenmesi ve HDV epidemiyolojisine ait veri toplaması amaçlandı. Gereç ve yöntem: Ağrı Devlet Hastanesi Ocak 2009-Mayıs 2012 tarihleri arasında gastroenteroloji ve enfeksiyon hastalıkları tarafından kronik hepatit B tanısıyla takip edilen hastaların anti-HDV, HDAg sonuçları ve demografik verileri retrospektif olarak incelendi. HBs Ag, Anti-HBc IgM tetkikleri makroeliza, anti-HDV ve HDAg tetkikleri ise mikroeliza yöntemiyle çalışıldı. Bulgular: Çalışmaya 315’i (%40,0) kadın, 472’si (%60,0) erkek olmak üzere toplam 787 hasta dahil edildi. Hastaların tamamında HBs Ag pozitif ve anti HBc IgM negatif olarak saptandı. Bu hastalardan 55’inde (%7,0) sadece Anti-HDV, 19(%2,4)’unda sadece HDAg pozitif olarak saptandı. İki (%0,3) olguda ise Anti-HDV ve HDAg birlikte saptandı. Toplam 76(%9,7) hastada HDV lehine pozitif bulgu saptandı. HDV pozitif hastaların yaş ortalaması 42,1±15,2 (11-77 yaş) olarak tespit edildi. Bunların 36’sı %47,4) kadın, 40’ı (%52,6) erkekti.Sonuç: Kronik viral hepatit hastalarında HDV enfeksiyonu hala önemini korumaktadır. Çalışmamızda HDV en- feksiyon oranı %9,7 olarak tespit edilmiştir. Bu oran, aynı bölgeden daha önce bildirilen çalışmalardan daha düşük olmasına rağmen ülke ortalamasının üzerindedir

Extracorporeal Shockwave Increases the Effectiveness of Systemic Antibiotic Treatment in Implant-Related Chronic Osteomyelitis: Experimental Study in a Rat Model

Kaya, Ertugrul/0000-0003-0081-682XWOS: 000333716100003PubMed: 24676969Implant-related chronic osteomyelitis is a serious complication of orthopedic surgery requiring implant removal and radical debridement. Extracorporeal shockwave (ESW) have demonstrated significant bactericidal effectiveness in vitro and effectiveness and safety were evaluated in an animal model of osteomyelitis. In this experimental study, we aimed to test our hypothesis that the use of ESW together with systemic antibiotic treatment will provide synergy for the treatment of implant-related chronic osteomyelitis caused by methicillin-susceptible Staphylococcus aureus (MSSA). The proximal tibia of 32 rats was contaminated with (10)8CFU/ml methicillin-sensitive S. aureus (MSSA-ATCC 29213) and Kirschner-wires were placed into the medulla of the tibia. After 4 weeks, Kirschner-wires were removed and the rats were randomly divided into four groups: group I, untreated contaminated control group; group II, receiving only ESW therapy; group III, receiving only systemic teicoplanin; group IV, treated with a combination of ESW and systemic teicoplanin. ESW was applied twice to the infected limbs and all rats were sacrificed at the end of 8th week. The degree of tibial osteomyelitis was assessed by quantitative culture analysis. Bacterial counts in groups III and IV were significantly reduced relative to the control (p=0.002 and 0.001, respectively). The decrease in bacterial counts was more pronounced and significant in group IV compared to group III (p=0.024). In group II, bacterial counts also decreased, but the differences were in significant (p=0.068). Our experimental model suggests that ESW provides significant synergy for systemic antibiotic treatment. However, further clinical trials are required in order to use this treatment modality safely in patients, even though our study demonstrated successful results in the treatment of implant-related chronic osteomyelitis in rats. (c) 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:752-756, 2014

Antibacterial effects of curcumin: An in vitro minimum inhibitory concentration study

Aim: To evaluate the antibacterial effect of curcumin with the minimum inhibitory concentration (MIC) method in standard bacterial strains. Methods: The in vitro antibacterial activity of curcumin was evaluated against methicillin-sensitive Staphylococcus aureus (MSSA) (ATCC 29213), methicillin-resistant Staphylococcus aureus (MRSA) (ATCC 43300), Enterococcus faecalis (ATCC 29212), Bacillus subtilis (ATCC 6633), Pseudomonas aeruginosa (ATCC 27853), Escherichia coli (ATCC 25922) and Klebsiella pneumoniae (ATCC 700603) using the macrodilution broth susceptibility test method. After incubation in tubes, the antibacterial activity of curcumin was detected by a lack of turbidity, which indicated the inhibition of bacterial growth. The concentration in the tube with the highest dilution showing no turbidity was defined as the MIC. Results: The curcumin MIC values were 175 mg/ml, 129 mg/ml, 219 mg/ml, 217 mg/ml, 163 mg/ml, 293 mg/ml and 216 mg/ml against P. aeruginosa, B. subtilis, MSSA, MRSA, E. coli, E. faecalis and K. Pneumonia, respectively. Conclusion: This study revealed antibacterial effects of curcumin against standard bacterial strains in high concentrations. Animal experiments have demonstrated that curcumin applied at high doses has strong antibacterial activity. There is a need for further in vivo studies to shed light on antibacterial effects of curcumin with high concentrations

Fascioliasis : a not rare cause of hypereosinophilia in developing countries, present in developed too

<p>Fascioliasis, which is a worlwide parasitic zoonosis,endemic in south-est mediterranean areas, but uncommon in other areas. Clinical signs are usually non-specific. A 32 year old male patient was admitted to our hospital with complaints of abdominal pain, diarrhea, fatigue, nausea, lost of apetite, itching, cough, night sweats and weight loss. Complete blood count revealed hypereosinophilia. The abdominal ultrasound scan was normal. But computed tomography scan revealed irregular nodular lesions in periportal area of the liver. Based on these clinical and radiological signs and continuous hypereosinophilia, the patient was serologically investigated for <em>Fasciola hepatica</em> infection. <em>F. hepatica</em> indirect hemagglutination test in serum was positive at a titer of 1/1280. Single dose Triclabendasole 10mg/kg was administered and repeated two weeks later. Clinical and laboratory signs were completely resolved after treatment.  Serological tests for fascioliasis should be included in all patients with  hypereosinophilia and abnormal liver CT.</p&gt

Comparıson of toxın genes ın staphylococcus aureus ısolates obtaıned from patıents and carrıers

WOS: 000330151200009It is important to have information about virulence characteristics of S. aureus isolates obtained from the nasal cultures of carriers in terms of the capability to cause severe infections. in the present study, S. aureus isolates obtained from carriers and isolates obtained from clinical specimens, and which were determined as causative agents of infection, were compared in terms of the genes of staphylococcal enterotoxiiz A and 8 (sea and seb), TSST-I (tst), and PVL (pv1). A total of 44 S. aureus strains isolated from clinical specimens and 44 carrier isolates were tested for the genes with polyinerase chain reaction method. As the results, the most common gene was sea with a rate of 45.5% (40188). This gene was found in 34.1% (15144) of the carrier isolates and in 56.8% (25144) of the clinical group. Furthermore, the presence of the sea gene was found to be significantly higher in the clinical isolates than in the carriers' (P=0.032). the tst, seb, and pvl genes were positive at rates of 18.2% (16188). 4.5% (4188), and 5.7% (5188), respectively. No significant differences were found between the groups according to positivity rates of the tst, seb, and pvl genes (p>0.05 for each gene) To our knowledge, differences between carrier isolates and clinical isolates in terms of toxin genes have not been investigated before the present study. the presence of sea at a significantly higher rate in clinical isolates shows the need for advanced molecular analysis on this topic.Abant Izzet Baysal Scientific Research ProjectsAbant Izzet Baysal University [2013.08.01.610]This study was supported by Abant Izzet Baysal Scientific Research Projects (Project No: 2013.08.01.610)