Hepatitis A Virus and Hepatitis E Virus Seroprevalence in Izmir

Genellikle çocukluk çağında görülen hepatit A virüsü (HAV) ve daha çok genç erişkinlerde görülen hepatit E virüsü (HEV) infeksiyonları birçok tropikal ve subtropikal ülkede, özellikle de hijyen koşullarının iyi olmadığı, kişilerin eğitim ve ekonomik düzeylerinin kötü olduğu toplumlarda çeşitli büyüklüklerde epidemiler şeklinde veya sporadik olarak görülür. Bir toplumda hepatit A ve E gibi geniş kitleleri ilgilendiren hastalıklarda koruyucu önlemleri belirlemek için, hastalığın o toplumdaki seroprevalansının ve yıllar içindeki değişiminin belirlenmesi önemlidir. Bu çalışmada İzmir il merkezinde farklı sosyoekonomik düzey ve yaş grubundaki kişilerde HAV ve HEV infeksiyonu seroprevalansını belirlemeyi ve geçmişte yapılan çalışmalar ile karşılaştırmalı olarak değerlendirmeyi amaçladık.Materyal ve Metod: Araştırmanın evrenini Türkiye İstatistik Kurumu (TÜİK) 2013 verilerine göre, İzmir ili merkez ilçelerinde yaşayan 7-80 yaş arası nüfus oluşturmaktadır. TÜİK'ten İzmir ili merkez ilçe ve mahalle nüfuslarına göre basit rastgele tabakalandırılmış (orantılanmış) adres bilgileri alındı. Kasım 2013-Ocak 2014 tarihleri arasında haneler gezilerek 424 kişiden 5-10 cc venöz kan örneği alındı. Her serum örneğinden HAV IgG (Abbott Architect MEIA, Germany) ve HEV IgG (Dia.Pro Diagnostic Bioprobes EIA, İtalya) testleri çalışıldı.Bulgular: Çalışmaya alınan grubun %83.2 (n= 358)'sinde anti-HAV IgG, %6.6 (n= 28)'sında anti-HEV IgG pozitif saptandı. Anti-HAV IgG pozitif saptananların 6 (%30)'sı çocuk, 352 (%87.1)'si erişkin; anti-HEV IgG pozitif saptananların ise tamamı erişkin yaş grubundaydı. HAV seropozitifliği; Ege bölgesi dışında doğmuş olanlarda (p= 0.000), hayatının büyük kısmını Ege bölgesi dışında geçirmiş olanlarda (p= 0.017), evlilerde (p= 0.000), çalışmayanlarda (p= 0.011), aylık geliri <= 1000 TL olanlarda (p= 0.011), hastanede yatış veya operasyon öyküsü olanlarda (p= 0.000) ve askerlik yapmış olanlarda (p= 0.019) diğer gruplara göre yüksek saptandı. HEV seropozitifliği ise; erkeklerde (p= 0.017), Ege bölgesi dışında doğmuş olanlarda (p= 0.000) ve askerlik yapmış olanlarda (p= 0.000) diğer gruplara göre yüksek saptandı.Sonuç: Bölgemizde HAV seropozitifliği %83.2, HEV seropozitifliği %6.6 bulunmuştur. Her iki virüsün bilinen epidemiyolojisine uygun olarak yetişkinlerde pozitiflik oranı çocuklardan daha yüksek bulunmuştur. HAV seropozitifliği Ege bölgesi dışında doğmuş ve hayatının büyük kısmını Ege bölgesi dışında geçirmiş olanlarda, düşük gelir düzeyine sahip olanlarda, evlilerde, hastanede yatış veya operasyon öyküsü olanlarda, askerlik yapmış olanlarda; HEV seropozitifliği ise; erkeklerde, Ege bölgesi dışında doğmuş olanlarda ve askerlik yapmış olanlarda istatistiksel olarak anlamlı derecede yüksek saptanmıştır. Korunmada; eğitim düzeyinin yükseltilmesi, sosyoekonomik durumun düzeltilmesi ve rutin aşılamanın ön planda tutulması gerektiği düşünülmüştür.Hepatitis A virus (HAV) infection which usually is seen in childhood and hepatitis E virus (HEV) infection which is observed more frequent in young adulthood, occurs as epidemics and also sporidically mostly in tropical and subtropical countries, that has poor hygene conditions and poor socio-economical status. Defining the seroprevalance of the disease and changes in years in a population, is very important for determining the protective measures of HAV and HEV that influences wide populations. In this study our aim was to determine the seroprevalance of HAV and HEV infections and to do the comperative evaulation with previous studies in our region. Materials and Methods: Serum samples were taken from 424 healthy subjects at age 7-80 years in the central district of Izmir between November 2013 and January 2014. HAV IgG (Abbott Architect MEIA, Germany) and HEV IgG (Dia.Pro Diagnostic Bioprobes EIA, Italy) were determined using macro and micro EIA methods in Ege University Medical Faculty Department of Medical Microbiology. A questionnaire form was used to survey the socioeconomic characteristics. Results: Of the 424 subjects, 358 (83.2%) were positive of anti-HAV IgG and 28 (6.6%) were positive of anti-HEV IgG. Anti-HAV IgG positivity was 30% (n= 6) in pediatric group, 87.1% (n= 352) in adult group. Anti-HEV IgG positivity was %100 (424) in adult group. Anti-HAV seroprevalence of subjects born outside the Aegean region (p= 0.000), who spent most of their life outside the Aegean region (p= 0.017), married (p= 0.000), unemployed (p= 0.011), monthly income being &lt;= 1000 TL (p= 0.011), once hospitalized or once operated (p= 0.000) and in soldiers (p= 0.019) were found to be higher compared to other groups. Anti-HEV seroprevalance of subjects born outside the Aegean region (p= 0.000), in males (p= 0.017) and in soldiers (p= 0.019) were found to be higher compared to other groups. Conclusion: Anti-HAV IgG positivity was 83.2% (n= 358) and anti-HEV IgG positivity was 6.6% (n= 28) in our region. As expected for both viruses, seropositivity in adults was higher than children. HAV seroprevalence of subjects born outside the Aegean region, who spent most of their life outside the Aegean region, married, unemployed, monthly income being &lt;= 1000 TL, once hospitalized or once operated and in soldiers; HEV seroprevalance of subjects born outside the Aegean region, in males and in soldiers were found to be statistically significantly higher compared to other groups. Improving education levels/socioeceonomic status and vaccination are important for protection

Antibiyotikle ilişkili nozokomiyal diyarelerde clostridium difficile toksin A araştırılması

Clostridium difficile has been recognized as the major cause of nosocomial diarrhea and pseudomembranous colitis in persons receiving antibiotic therapy. The aim of the present study was to determine the prevalence of C. difficile in nosocomial diarrhea. Stool specimens of 38 patients hospitalized in intensive care units for more than three days receiving antibiotic therapy and then developed diarrhea were tested for Clostridium difficile toxin A with a commercial enzyme linked fluorescent assay (bio Merieux Vitek, France). Toxin A was found in the stool specimens of seven (18.4%) patients.Clostridium difficile, antibiyotik ile ilişkili nozokomiyal diyare ve psödomembranöz kolit olgularından sorumlu olan bir bakteridir. Bu çalışmanın amacı, nozokomiyal diyarelerde C. difficile yerini belirlemek idi. Yoğun bakım ünitelerinde üç günden fazla yatarak antibiyotik kullanan ve diyare gelişen 38 hastaların dışkı örneklerinde "enzyme linked fluorescent assay" (bio Merieux Vitek, Fransa) ile C. difficile toksin A araştırıldı. Olguların yedisinin (%18.4) dışkı örneğinde C. difficile toksin A olumlu bulundu

The tetanus antibody levels in the people living with HIV in a Turkish HIV care centre

03325 The tetanus antibody levels in the people living with HIV in a Turkish HIVcare centre10. Immunology &amp; VaccinologyA. Nazli 1, B. Kenanoglu 2, M. Isikgoz Tasbakan 2, H. Pullukcu 2, A. Zeytinoglu 3, D. Gokengin 31Dokuz Eylul University Medical Faculty Infectious Diseases and Clinical MicrobiologyDepartment - Izmir (Turkey), 2Ege University Medical Faculty Infectious Diseases andClinical Microbiology Department - Izmir (Turkey), 3Ege University Medical Faculty MedicalMicrobiology Department - Izmir (Turkey)BackgroundEven in the golden age highly active antiretroviral therapy, the people living with HIVhave risk of complications from vaccine-preventable diseases. In Turkey, adults wereroutinely vaccinated during pregnancy or military service and recommended a rappeldose after 10 years. There is a lack of routine vaccination program for the peopleliving with HIV. We aimed to investigate the levels of tetanus antibody levels and thefactors related in the people living with HIV who attended our centre.MethodsWe included the people living with HIV who attended Ege University Medical FacultyInfectious Disease HIV care outpatient clinic who accepted the informed consent togive blood sample. We used Enzyme-Linked Immuno Sorbent Assay kit to testtetanus antitoxin IgG levels. We recorded age, sex, the vaccination history, CD4 Tcell count during vaccination, the time of HIV diagnosis retrospectively.ResultsWe included 146 people living with HIV in our study. The 86, 3% was male sex. Themean age was 39.5 years (±11.20). The mean CD4 T cell count was 485 ±279.18 (1-1331) / mm3. One hundred and fourteen (78.1%) participants had the protectiveantibody level. The rappel dose recommendations according to antibody levelwere immediate rappel dose to 32 (21.9%), in five years to 37(25.3%), in ten yearsto 69 (47.3%) and after ten years to eight (5.5%) participants. In the multi variateanalysis, the related factors for protective antibody level were CD4 T cell count&gt;218/ mm3 during vaccination (p= 0,043, OR: 4.28; 95 % CI(1,05-17,44) and age ≥43 years (p= 0,0001, OR:30,6 (6,51-144,2). One hundred seven (73.2 %)participants had vaccination history. The duration of vaccination and the antibodylevels were uncorrelated.ConclusionsThe protective antibody levels for tetanus vaccine were low independent of thevaccination time in the people living with HIV. In every five years, testing of tetanusantibody level or rappel dose can protect them for the future infections.</p

Comparison of Brucella immunoglobulin M and G flow assays with serum agglutination and 2-mercaptoethanol tests in the diagnosis of brucellosis

The diagnostic value of Brucella IgM/IgG flow assays was evaluated in comparison with serum agglutination and 2-mercaptoethanol tests by testing a selection of serum samples submitted to the laboratory because of clinical suspicion of brucellosis. All 39 admission and 11 follow-up samples that agglutinated in the serum agglutination test tested positive in the flow assay, whereas all 20 serum agglutination negative samples with clinical suspicion of brucellosis, 23 control samples from healthy individuals and 20 control samples from cases with chronic hepatitis tested negative in the flow assay. The Brucella IgM and IgG flow assays were slightly more sensitive than the agglutination tests in discriminating between specific IgM and IgG antibodies. The Brucella IgM and IgG flow assays are easy-to-perform and quick assays that can be used for the diagnosis of brucellosis. The flow assays are very useful, especially in rural settings where brucellosis is widespread and where well-equipped laboratories to perform the laboratory tests are not readily availabl

Should Tetanus Vaccine Booster be Given Earlier in Individuals Living with HIV?

The incidence rate of tetanus has dramatically decreased following the discovery of the tetanus vaccine. A decennial booster dose is necessary to maintain the protective antibody levels after the primary vaccination schedule. The recommendations for the tetanus booster doses in adult "people living with acquired immune deficiency virus (HIV)" (PLWH) is similar to those for the general population. However, the duration of protective antibodies in PLWH is unknown. The aim of this study was to determine the factors affecting the response of HIV-infected individuals to tetanus vaccine and to evaluate the role of tetanus antitoxin level in determining the timing of the booster dose. PLWH attending the Adult Vaccination Unit of Ege University Faculty of Medicine Infectious Diseases and Clinical Microbiology Department were tested for tetanus antibodies from 30 October to 30 November 2020. Demographic information and the history of primary vaccination and booster doses were derived from medical files. Tetanus antibodies were detected with "enzyme immunoassay (EIA)" method with Clostridium tetani toxin 5S IgG-"enzyme linked immunosorbent assay (ELISA)" kit (Nova Lisa, Novatec Immundiagnostica, Germany). Antibody levels 1.1 IU/ml strong positive. A level >= 0.50 IU/ml was considered as protective. The study included 146 PLWH [men (n= 126) and women (n= 40)]. The mean age was 39.5 +/- 11.20 years (range: 18-65). Protective antibody level was detected in 114 (78.1%) participants. Receiver operating characteristics (ROC) analysis revealed that the ideal lower limit of CD4+ T cell count during booster vaccination for a person to develop protective antibody level was calculated as >= 218 cell/mm(3). In the multivariate analysis, it was found that age 50 years old, with CD4+ T lymphocyte count < 200 cells/mm(3) during previous booster vaccination and who had AIDS at the time of the diagnosis