Hidden Danger: Superbug Escherichia coli Isolated from Urine Isolates of Outpatient Women with Uncomplicated Urinary Tract Infection

BACKGROUND/AIMS Escherichia coli (E. coli) is responsible for the vast majority of uncomplicated bacterial urinary tract infection (UTI) cases in women. The high ability of the isolates to develop antimicrobial resistance makes the treatment difficult. In this study, we investigated the presence of plasmid-mediated quinolone resistance (PMQR) genes in E. coli isolates and their relationship with extended-spectrum beta-lactamases (ESBL). MATERIAL and METHODS A total of 300 E. coli isolates from urine specimens of women, including 108 ESBL producers and 192 non-ESBL producers, were analyzed. The ESBL production was examined using the E-test ESBL strips, and the carbapenemase activity was examined using the CarbaNP test. The presence of PMQR genes (qnrA, qnrB, qnrS, and aac (6´)-Ib) among urine isolates was investigated using polymerase chain reaction. Conjugation experiments were performed to detect the horizontal transferability of the PMQR-positive plasmid. RESULTS Among the ESBL-EC isolates, ciprofloxacin resistance was determined at 69%. Eight isolates were resistant to carbapenems. The aac(6’)-Ib-cr variant was found in 40% of ciprofloxacin-resistant E. coli isolates. None of the isolates harbored the qnrA, qnrB, or qnrS gene. The transferability was 14% for aac(6’)-Ib-cr. The MICs of transconjugants showed increased resistance to fluoroquinolones compared with the recipient E. coli J53AzR. CONCLUSION: This study showed that the frequency of PMQR genes in ESBL-producing superbug E. coli isolates reduced therapeutic options for treating community-acquired UTIs in affected women and that a careful use of antibiotics is very important

Anaerobic infection in preauricular lesion

Preauriküler sinüs, kulak katlantısının ön, üst kısmında, çoğunlukla sağ tarafta görülür. Birinci faringeal katlantının dorsal kısmının tam olmayan kapanması sonucu oluşur. Genellikle bulgu vermez. Enfekte olgular klini- ğe gelişin en sık nedenidir. Çoğunlukla etken stafilokok’tur. Sağaltım bulgulara yönelik yapılır. Yineleyen olgularda lezyonun cerrahi olarak çıkartılması önerilir. Çalışmada, preauriküler abse materyalinde, aerobik kültür ve konvansiyonel PZR yöntemleri ile bakteriyel ve viral patojenler araştırılması amaçlanmıştır.Preauricular sinuses are seen in the anterosuperior part of the auricle, usually on the right side. They occur due to the incomplete closure of the dorsal part of first branchial cleft. Most sinuses are clinically silent. Infection is the most common cause of referring to a clinic. The agent is usually staphylococci. Debridment is tailored according to the findings. In recurring cases, surgical removal of the lesion is recommended. In this study, bacterial and viral pathogens were investigated by aerobic culture an

Hidden Danger: Superbug escherichia coli isolated from urine isolates of outpatient women with uncomplicated urinary tract infection

BACKGROUND/AIMSEscherichia coli (E. coli) is responsible for the vast majority of uncomplicated bacterial urinary tract infection (UTI) cases in women. The high ability of the isolates to develop antimicrobial resistance makes the treatment difficult. In this study, we investigated the presence of plasmid-medial ed quinolone resistance (PMQR) genes in E. coli isolates and their relationship with extended-spectrum beta-lactomoses (ESBL).MATERIAL and METHODSA total of 300 E. coli isolates from urine specimens of women, including 108 ESBL producers and 192 non-ESBL producers, were analyzed. The ESBL production was examined using the E-test ESBL strips, and the carbapenemase activity was examined using the CarbaNP test. The presence of PMQR genes (qnrA, qnrB, qnrS, and aac (6')-lb)among urine isolates was investigated using polymerase chain reaction. Conjugation experiments were performed to detect the horizontal transferability of the PMQR-positive plasmid.RESULTSAmong the ESBL-EC isolates, ciprofloxacin resistance was determined at 69%. Eight isolates were resistant to carbapenems. The aac(6')-lb-crvariant was found in 40% of ciprofloxacin-resistant E. coli isolates. None of the isolates harbored the qnrA, qnrB, or qnrS gene. The transferability was 14% for aac(6)-lb-cr. The MICs of transconjugonts showed increased resistance to fluoroquinolones compared with the recipient E. coli-153AzR.CONCLUSION: This study showed that the frequency of PMQR genes in ESBL-producing superbug E. coli isolates reduced therapeutic options for treating community-acquired UTIs in affected women and that a careful use of antibiotics is very important

Anaerobic infection in preauricular lesion

Preauriküler sinüs, kulak katlantısının ön, üst kısmında, çoğunlukla sağ tarafta görülür. Birinci faringeal katlantının dorsal kısmının tam olmayan kapanması sonucu oluşur. Genellikle bulgu vermez. Enfekte olgular klini- ğe gelişin en sık nedenidir. Çoğunlukla etken stafilokok’tur. Sağaltım bulgulara yönelik yapılır. Yineleyen olgularda lezyonun cerrahi olarak çıkartılması önerilir. Çalışmada, preauriküler abse materyalinde, aerobik kültür ve konvansiyonel PZR yöntemleri ile bakteriyel ve viral patojenler araştırılması amaçlanmıştır.Preauricular sinuses are seen in the anterosuperior part of the auricle, usually on the right side. They occur due to the incomplete closure of the dorsal part of first branchial cleft. Most sinuses are clinically silent. Infection is the most common cause of referring to a clinic. The agent is usually staphylococci. Debridment is tailored according to the findings. In recurring cases, surgical removal of the lesion is recommended. In this study, bacterial and viral pathogens were investigated by aerobic culture an

Five methods for detection of Helicobacter pylori in the Turkish population

AIM: To compare culture analysis, Helicobacter pylori (H. pylori) stool antigen (HpSA) test, polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) for H. pylori detection

The distribution of genotype of the Hepatitis C virus (HCV) RNA positive patients

Amaç: Flaviviredea ailesinden bir virus olan Hepatit C virusu(HCV) akut hepatitlerin %20’si, kronik hepatitlerin % 70’inden sorumludur. HCV’nin genotip tayini tedavide ve klinik sürecin takibinde önemlidir. Çalışmamızda Afyon Kocatepe Üniversitesi Tıp Fakültesi Mikrobiyoloji laboratuarına kan örnekleri gönderilen 34 HCV RNA pozitif hastada genotip dağılımının saptanması amaçlanmıştır. Yöntem: Örneklerin genotiplendirilmesinde Geno Sen’s HCV Genotyping 1/2/3/4 Real Time PCR Reagents Kiti (Corbett Research, Australia) kullanılmıştır. Hastaların viral yükleri 34x103 ile 17x106 arasında bulunmuş olup viral yük ortalamaları ise 46x105 olarak saptanmıştır. Çalı- şılan 34 örnekten 31’i genotip 1, 3’ü genotip 4 olarak bulunmuştur. Sonuç: Sonuç olarak klinik sürecin takibi ve antiviral tedavi seçiminde genotip tayinin yol gösterici olması sebebiyle bu tip çalışmaların önemli olduğu düşünülmektedir.Objective: Hepatit C virus (HCV), which is a virus from the family Flaviviredea, is responsible for 20% of acute hepatitis and 70% of chronic hepatitis. Determination of HCV genotype is important in the treatment and the clinical follow-up process. In this study, we aimed to determine the genotype distribution of 34 HCV RNA positive patients whose sera were sent to Afyon Kocatepe University, Faculty of Medicine Microbiology laboratory. Method: Geno Sen’s HCV Genotyping 1/2/3/4 Real Time PCR Reagents Kit (Corbett Research, Australia) was used for genotype determination of those samples. Patients’ viral loads were found between 34x103-17x106 and mean viral load was 46x105. Thirty one samples, out of 34, were found genotype 1 while the other 3 samples were found genotype 4. Results: Consequently, this type of studies are considered to be crucial since genotype determination has a guiding role in clinical follow-up process and the selection of antiviral therapy

Investigation of mecA genes in staphylococcus strains isolated from clinical samples

Amaç: Staphylococcus aureus geniş bir spektrumda enfeksiyonlara neden olan, özellikle metisiline dirençli suşları ile ciddi hastane enfeksiyonları oluşturan bir etkendir. Uzun süreli antibiyotik kullanımı direnç gelişimi için önemli olup bu direnci (metisilin ve diğer beta-laktam antibiyotiklere) mecA geni oluşturur. Tedavisi oldukça zor ve maliyetlidir. Bu yüzden metisiline dirençli S. aureus (MRSA) suşlarının doğru tanısı çok önemlidir. Gereç ve yöntem: Bu çalışmaya 2004-2005 yılları arasında çeşitli klinik örneklerden izole edilen 193 stafilokok izolatı dahil edilmiş olup (S.aureus %79.3, koagülaz negatif stafilokok %20.7) suşlarda metisilin direnci Clinical and Laboratory Standards Institute (CLSI) önerilerine göre oksasilin disk difüzyon yöntemiyle gerçekleştirilmiştir. Örneklerde mecA gen varlığı PCR ile araştırılmıştır. Bulgular: Çalışmada toplam 193 Stafilokok incelenmiştir (Staphylococcus aureus %79.3, koagülaz negatif stafilokok %20.7). Oksasilin disk difüzyon yöntemiyle 141 izolat metisiline dirençli bulunurken PCR metoduyla 144 izolatta mecA gen varlığı saptanmıştır. İki metod arasında anlamlı istatistiksel fark görülmemiştir. PCR çalışmalarıyla ortaya konan mecA gen varlığı temel alınarak yapılan karşılaştırmada disk difüzyon yönteminin MRSA tespiti için sensitivitesinin %96.5, spesifitesinin %96.0 olduğu gözlenmiştir. Sonuç: Stafilokoklarda metisilin direncinin saptanmasında en güvenli yöntemin PCR yardımıyla mecA gen varlığının araştırılması olduğu, bunun yanı sıra disk difüzyon yönteminin de ucuz, kolay ve spesifik bir alternatif olabileceği kanısına varılmıştır.Aim: Staphylococcus aureus is a potentially pathogenic that causes a board spectrum of infections. Methicillin resistant S. aureus (MRSA) is also one of the important pathogens causing hospital infections, which is a global problem. The long time use of antibiotics this microorganism developed important resistance mechanisms. Resistance to methicillin and other beta-lactam antibiotics is caused by mecA gene. Treatment is fairly difficult and costly. Therefore it is very important to correctly diagnose these MRSA. Material and methods: In this study, samples were isolated from various clinical materials collected between 2004-2005. Staphylococci isolated from clinic speciments were screened for methicillin resistance by oxacillin disc diffusion method according to the Clinical and Laboratory Standards Isntitue (CLSI) guidelines. Afterwards all strains were tested for the presence of the mecA gene by PCR. Results: A total of 193 Staphylococci were analyzed (Staphylococcus aureus 79.3%, coagulase negative Staphylococci 20.7%). One hundred forty one isolates were found oxacillin-resistant by disc diffusion method. One hundred forty four isolates were found mecA positive by PCR. There were no significant differences for two methods. Compared with, mecA gene PCR assay's the sensitivity and specificity of disk diffusion for detecting MRSA were found 96.5% and 96.0% respectively. Conclusion: The detection of mecA gene by PCR is most reliable approach for MRSA, nevertheless disc diffusion is quite useful and specific method which can be used as a method in clinical microbiological laboratory

Investigation of mecA genes in staphylococcus strains isolated from clinical samples

Amaç: Staphylococcus aureus geniş bir spektrumda enfeksiyonlara neden olan, özellikle metisiline dirençli suşları ile ciddi hastane enfeksiyonları oluşturan bir etkendir. Uzun süreli antibiyotik kullanımı direnç gelişimi için önemli olup bu direnci (metisilin ve diğer beta-laktam antibiyotiklere) mecA geni oluşturur. Tedavisi oldukça zor ve maliyetlidir. Bu yüzden metisiline dirençli S. aureus (MRSA) suşlarının doğru tanısı çok önemlidir. Gereç ve yöntem: Bu çalışmaya 2004-2005 yılları arasında çeşitli klinik örneklerden izole edilen 193 stafilokok izolatı dahil edilmiş olup (S.aureus %79.3, koagülaz negatif stafilokok %20.7) suşlarda metisilin direnci Clinical and Laboratory Standards Institute (CLSI) önerilerine göre oksasilin disk difüzyon yöntemiyle gerçekleştirilmiştir. Örneklerde mecA gen varlığı PCR ile araştırılmıştır. Bulgular: Çalışmada toplam 193 Stafilokok incelenmiştir (Staphylococcus aureus %79.3, koagülaz negatif stafilokok %20.7). Oksasilin disk difüzyon yöntemiyle 141 izolat metisiline dirençli bulunurken PCR metoduyla 144 izolatta mecA gen varlığı saptanmıştır. İki metod arasında anlamlı istatistiksel fark görülmemiştir. PCR çalışmalarıyla ortaya konan mecA gen varlığı temel alınarak yapılan karşılaştırmada disk difüzyon yönteminin MRSA tespiti için sensitivitesinin %96.5, spesifitesinin %96.0 olduğu gözlenmiştir. Sonuç: Stafilokoklarda metisilin direncinin saptanmasında en güvenli yöntemin PCR yardımıyla mecA gen varlığının araştırılması olduğu, bunun yanı sıra disk difüzyon yönteminin de ucuz, kolay ve spesifik bir alternatif olabileceği kanısına varılmıştır.Aim: Staphylococcus aureus is a potentially pathogenic that causes a board spectrum of infections. Methicillin resistant S. aureus (MRSA) is also one of the important pathogens causing hospital infections, which is a global problem. The long time use of antibiotics this microorganism developed important resistance mechanisms. Resistance to methicillin and other beta-lactam antibiotics is caused by mecA gene. Treatment is fairly difficult and costly. Therefore it is very important to correctly diagnose these MRSA. Material and methods: In this study, samples were isolated from various clinical materials collected between 2004-2005. Staphylococci isolated from clinic speciments were screened for methicillin resistance by oxacillin disc diffusion method according to the Clinical and Laboratory Standards Isntitue (CLSI) guidelines. Afterwards all strains were tested for the presence of the mecA gene by PCR. Results: A total of 193 Staphylococci were analyzed (Staphylococcus aureus 79.3%, coagulase negative Staphylococci 20.7%). One hundred forty one isolates were found oxacillin-resistant by disc diffusion method. One hundred forty four isolates were found mecA positive by PCR. There were no significant differences for two methods. Compared with, mecA gene PCR assay's the sensitivity and specificity of disk diffusion for detecting MRSA were found 96.5% and 96.0% respectively. Conclusion: The detection of mecA gene by PCR is most reliable approach for MRSA, nevertheless disc diffusion is quite useful and specific method which can be used as a method in clinical microbiological laboratory