The Investigation of Seroprevalance of Brucellosis and Related Factors with A Questionnaire in Mersin Province

Brucellosis seropositivity was searched using serum agglutination test on some selected groups in Mersin province between October and November 2003. In this study, Brucella abortus antigen provided from Pendik Veterinarian Research Institute was used. Sera with titers equal or more than 1/10 were accepted as positive. A questionnaire was applied to the subjects to reveal sociodemographic properties, animal occupation, consumption of milk and milk products and complaints about brucellosis. In a population of 600 persons, the seroprevalence rate of brucellosis was found as 13.2%. The relationships between agglutination test positivity and educational background, settlement place, occupation, animal breeding, consumption of milk and milk products, and complaints of loss of appetite and weight loss were found significant

The concentration and seasonal distribution of airborne aeroallergen fungi spores

Amaç: Küfler soluduğumuz havada en fazla miktarda bulunan partiküllerdir ve aeroallerjen fungus sporları uygun koşullarda atmosferde yaygın olarak bulunabilirler. Duyarlı bireylerde konjuktiva, solunum, deri ve burun mukozası gibi yollarla vücuda girerek alerjik rinit, astım, konjunktivit gibi semptomların ortaya çıkmasına neden olabilirler. Bu çalışmada, Mersin atmosferinde bulunan fungus sporlarının tanımlanması ve meteorolojik faktörlere bağlı olarak spor konsantrasyonlarında meydana gelen değişiminin incelenmesi amaçlanmıştır. Gereç ve Yöntem: 2007 Eylül-2008 Kasım ayları arasında Mersin iline bağlı 4 merkez ve 2 çevre ilçeden, toplam 9 seferde 549 örneklem yapılmıştır. Taşınabilir hava örnekleme cihazı airIDEAL (bioMérieux, Fransa)'in haznesine yerleştirilen Sabouraud Dekstroz Agar yüzeyine ekim yaptırılmıştır. Üreyen küf kolonilerinin yedinci günden itibaren makroskobik ve mikroskobik morfolojilerine göre değerlendirilmesiyle cins düzeyinde tanımlamaları yapılmıştır. Bulgular: Çalışma süresince 33 mantar taksonuna ait toplam 298.220 CFU küf mantarı izolasyonu yapılmıştır. İzole edilen küflerin %71.75'i Cladosporium, %16.35'i Penicillium, %6.31'i Aspergillus, %3.42'si Alternaria, %0.83'ü Fusarium olarak tanımlanmış; diğer cinsler ise atmosferdeki sporların %1.34'ünü oluşturmuştur. En sık rastlanan küflerin spor konsantrasyonlarının mevsimsel dağılımına bakıldığında; çalışmamızda en sık rastlanan Cladosporium, Alternaria ve Penicillium cinsleri her mevsiminde artış gösterirken, Fusarium ve Aspergillus cinsleri yaz ve sonbahar aylarında en yüksek seviyede tespit edilmiştir. Fungus sporlarının yoğunluğunun meteorolojik parametreler ile ilişkisine bakıldığında ise; Alternaria, Cladasporium ve Fusarium spor miktarlarının sıcaklık, nem ve rüzgâr ile istatistiksel olarak pozitif, Penicillium'un negatif korelasyon gösterdiği tespit edilirken, Aspergillus'un yalnızca sıcaklık ile pozitif korelasyon gösterdiği saptanmıştır.Sonuç: Bu çalışma, Mersin atmosferindeki allerjen ve toksijenik fungus sporlarının iklimsel verilerle beraber takibinin yapıldığı ilk çalışma olması bakımından önem taşımaktadır. Ayrıca çalışmadan elde edilen verilerin, duyarlı bireylerin tanı ve tedavisinde yararlı olacağı umut edilmektedirObjective: Molds are the most abundant particles in our breathing air and aeroallergen fungi spores are commonly found in the atmosphere under suitable conditions. They enter the body through different routes such as conjunctiva, respiratory tract, skin and nasal mucosa. They may lead to allergic rhinitis, asthma and conjunctivitis in susceptible individuals. In this study we aimed to identify the fungal spores in the atmosphere and investigate the alterations in spore concentrations in relation to the meteorological factors. Materials and Methods: A total of 549 air samples were taken from four different central and two peripheral districts of Mersin province, Turkey, for nine times between September 2007 and November 2008. Air samples were inoculated onto the surface of the Sabouraud’s Dextrose Agar by using portable air sampler (airIDEAL, bioMérieux, France). The growing fungi were defined to the genus level by evaluating the macroscopic and microscopic morphology starting from the seventh day of the isolated mold colonies. Results: A total of 298.220 CFU belonging to 33 fungi taxons were isolated during the study. These spores belonged to the Cladosporium spp. (71.75%), Penicillium spp. (16.35%) Aspergillus spp. (6.31%), Alternaria spp. (3.42%), and Fusarium spp. (0.83%). The other taxa consisted a total of 1.34% of all atmospheric spores. When the seasonal distribution of the most common mold spore concentrations were investigated, Fusarium and Aspergillus genera were detected most frequently in summer and autumn months, while Penicillium, Cladosporium and Alternaria genera were abundant in every season. The correlation between the density of fungal spores and meteorological parameters revealed that amount of Alternaria, Cladosporium and Fusarium spores were positively correlated with temperature, humidity and wind, while amount of Penicillium spores indicated a negative correlation. Additionally, the amount of Aspergillus spores correlated only with temperature. Conclusion: This study is the first study which investigated the correlation between allergen and toxigenic fungi spores and the climatic data in Mersin, Turkey. The data obtained in this study might be useful for the evaluation and the treatment of susceptible individuals in that area

Antimicrobial Resistances of Escherichia coli Isolates Causing Bacteremia (2004-2009)

Introduction: Escherichia coli is the most frequently isolated microorganism causing nosocomial and community-onset bacteremia. The aim of the present study was to investigate antimicrobial resistance trends of E. coli isolates causing bacteremia. Materials and Methods: In this retrospective study conducted at the University of Mersin, antimicrobial resistances were evaluated in a total of 323 E. coli isolates causing bacteremia between January 2004 and January 2010. All E. coli species were isolated from the blood using the BACTEC 9240 system (Becton Dickinson, INC, Sparks, MD). Isolates were identified and antimicrobial susceptibility testing was performed using standard techniques. Extended-spectrum beta-lactamase production was assessed by the double-disk synergy test. Nosocomial bacteremia was defined as an infection not present or incubating at the time of hospital admission, with onset at least 48 hours after admission to the hospital. Antimicrobial resistance trends of E. coli isolates during two three-year periods (2004- 2006 and 2007-2009) were prospectively recorded, evaluated and compared. SPSS ver. 16 (Chicago, IL) statistical package program was used for statistical analysis. Results: Patients were analyzed; 58.2% were male, the mean age was 52.7 ± 24.7 (1-96) years, and duration of bacteremia was 7.9 ± 4.6 (1-23). Of these patients, 92.3% had nosocomial bacteremia due to E. coli. Overall mortality was 27.2%. Extended-spectrum beta-lactamase-producing strains were reported in 136 (42.1%) cases. During the six-year study period, resistance rates of E. coli isolates causing bacteremia increased from 42.6% to 67.9% for cefuroxime axetil (p=0.002), from 42.3% to 62.3% for trimethoprimsulfamethoxazole (p=0.003), from 37% to 57.9% for ciprofloxacin (p= 0.018), and from 29.6% to 53.6% for gentamicin (p=0.004). Resistance rates to imipenem remained very low and stable (from 1.1% to 1.9%). Quinolone resistance was significantly associated with extended- spectrum beta-lactamase-production (p=0.0001). Conclusion: We demonstrated a trend of increasing resistance among E. coli isolates causing bacteremia to four different classes of antimicrobials. Increasing resistance may have an impact on the choice of empirical antimicrobial therapy in patients with bacteremia

Investigation of Beta-Lactamases and Quinolone Resistance Genes in Clinical Isolates of Enterobacteriaceae

Introduction: The production of extended-spectrum beta-lactamases (ESBL) and their rapid spread among pathogenic bacteria-particularly Klebsiella species and Escherichia coli-pose serious threats for treatment. In this study, we aimed to investigate beta-lactamase resistance genes and quinolone resistance genes in ESBL-positive E. coli and Klebsiella pneumoniae strains. Materials and Methods: This study was performed by ESBL-positive 108 E. coli and 23 K. pneumoniae strains. Rep-PCR [Diversilab (Repetitive Extragenic Palindromic Element-Polymerase Chain Reaction)] analysis was made in order to examine colonial association in 100 E. coli strains among these isolates. Results: Out of 113 isolates, 112 (85.5%) were detected to have CTX-M group 1 enzyme, 43 (32.1%) isolates had TEM type, 44 (32.8%) had OXA type, 31 had both TEM and OXA types and 1 (0.76%) had both TEM and SHC type of beta-lactamases. Four (3%) isolates had CTX-M group 9, 6 (4.5%) had CTX-M group 1 and 9, 2 (1.5%) had CIT, 2 (1.5%) had OXA-48 and 1 (0.75%) had VIM type beta-lactamases. aac(6’)-Ib gene region responsible for resistance to quinolones was detected in 59 (54.2%) E. coli and 15 (62.5%) K. pneumoniae strains. In addition to this gene region, three E. coli isolates and one K. pneumoniae isolate were found positive for qnrS, one K. pneumoniae isolate was found positive for qnrB and one E. coli isolate was found positive for qepA genes. Two main clones were detected in E. coli strains by rep-PCR method. All strains found in the main clones were detected to have CTX-M group 1 and TEM type beta-lactamases and aac (6’) 1b quinolone-resistance gene. Conclusion: Majority of the ESBL-positive enteric bacteria isolated form clinical specimens were determined to have beta-lactamases and quinolone-resistance genes. It is observed that CTX-M group 1 and aac (6’)-Ib gene region are particularly common in ESBL-positive isolates that were isolated in our hospital

Investigation of anti- leishmanial activity of the ten different hydrazone derivatives

ULGER, Mahmut/0000-0001-6649-4195WOS: 000378899400006Leishmaniasis is an important parasitic disease in Turkey and the world. Anti-leishmanial drugs such as sodium stibogluconate, miltefosine, paramomycin, amphotericin B, and pentamidine are used for the treatment of leishmaniasis. However, the drugs, used for the chemotheraphy of leishmaniasis, have some side effects such as nephrotoxicity, hepatotoxicity, and teratogenicity. In addition, it is deemed that the discovery and development of the new therapeutic agents must be given priority due to the development of resistance against antimony compounds. The purpose of this study is detecting the anti-leishmanial activity of ten different synthesized hydrazone compounds against Leishmania infantum promastigotes via the microdilution method. The prepared hydrazone compounds, having the concentration of 6 mu g/ml, were added to RPMI-1640 media and the dilution of the hydrazone derivates was performed in the wells of microplates in the range of concentrations of 3 - 0.003 mu g/ml. The microdilution broth method in the microplates was prepared, than the adjusted standard Leishmania infantum promastigotes, 2.5x10(7)cells/mL, were added, into the mentioned microplates which was incubated in 27 degrees C. Twenty h later, the alamar blue were added on the microplates and they were incubated for 4 h. The proliferation of promastigotes was evaluated in 24, 48, and 72 h. It was considered that changing the color from blue to pink in the wells were exhibiting the growth of parasites, while the unchanged color was not. The present study has revealed that the most effective substances against Leishmania infantum promastigotes were 5e, 5g, and 5h compounds (MIC 0.187 mu g/ml) while the least effective compound was 5i (MIC 3 mu g/ml). There is a need for further studies on in vitro activity against the Leishmania amastigotes in macrophages cultures and in vivo experimental animal models for the synthesized compounds showing anti-leishmanial effect in the present study

Ege Üniversitesi ve Mersin Üniversitesi Tıp Fakültelerinin kan merkezlerine başvuran HBsAg negatif kan vericilerinde HBV-DNA varlığının araştırılması

Aim: Hepatitis B virus (HBV) remains important among the agents of blood transmitted infections. Although increased sensitivity of serological tests, detection of HBV-DNA by nucleic acid tests (NAT) techniques, especially by the individual NAT (ID-NAT) techniques for safe blood transfusion came into question. Materials and Methods: A total of 4352 HBsAg negative volunteer-donors in ages of 18-65 years admitted to the Blood Transfusion Centers of Ege University Faculty of Medicine and Mersin University Faculty of Medicine Hospital were included in the study between April 2010 and January 2011. The samples of the donors were tested with real- time polymerase chain reaction (RT-PCR) in order to detect HBV-DNA. Results: Following HBV-DNA screening, only two positive serum results were found. Test was repeated on two positive samples with both the same and an alternative method. Repeated tests resulted negative; therefore all samples were assessed as HBV-DNA negative. In all samples of HBsAg negative donors from two different centers, HBV-DNA was found to be negative. Conclusion: The number of blood donors included in the study and low seroprevalence of the centers could be the reason for no detection of occult HBV. Turkish Red Crescent routine NAT studies that began in 2014 will give appropriate data for occult HBV in our regionAmaç: Kan yoluyla bulaşan enfeksiyon etkenleri arasında hepatit B virüsü (HBV) önemini korumaktadır. Serolojik testlerin duyarlılığının arttırılmasına rağmen güvenli kan transfüzyonu için kanda HBV-DNA varlığını saptayan nükleik asit testi (NAT) uygulamaları, özellikle de tek tek örneklere uygulanan NAT (ID-NAT) uygulamaları gündeme gelmiştir. Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi Kan Merkezi ve Mersin Üniversitesi Tıp Fakültesi Sağlık Araştırma Uygulama Hastanesi Kan Merkezi’ne Nisan 2010 ile Ocak 2011 tarihleri arasında başvuran 18–65 yaşları arasındaki 4352 HBsAg negatif kan vericisinin serum örnekleri incelenmek üzere çalışmaya alındı. Kan vericilerinin örneklerinde HBV-DNA’yı saptamak amacıyla gerçek zamanlı polimeraz zincir reaksiyonu (RT-PCR) testi uygulandı. Bulgular: Çalışılan örneklerden sadece 2 serumda HBV-DNA şüpheli pozitif olarak saptandı. İki pozitif sonuç aynı yöntemle iki kez ve farklı alternatif yöntemlerle doğrulamak amacıyla tekrarlandı. Tekrarlanan örneklerin negatif bulunması sonucunda örneklerin tümünde HBV-DNA negatif olarak değerlendirildi. İki ayrı merkezden alınan HBsAg negatif kan vericilerinin tüm örneklerinde HBV-DNA negatif bulundu. Sonuç: Çalışmaya alınan kan vericilerin sayısı ve merkezlerdeki düşük seroprevalans gizli HBV görülmemesinin nedeni olabilir. Türk Kızılayı’nın 2014’de başlayan rutin NAT çalışmaları bölgemizdeki gizli HBV verilerini daha net ortaya çıkaracaktı

Genotyping of vaginal candida glabrata isolates using microsatellite marker analysis and DNA sequencing to identify mutations associated with antifungal resistance

Vulvovajinal kandidoz, vajinitlerin en sık ikinci sebebi olup (%17-39), hemen daima ilk sırada yer alan (%22-50) bakteri vajinitini izlemektedir. Tanı genellikle klinik olarak, mikolojik doğrulama testleri yapılmaksızın konulduğundan ve ampirik tedavi uygulandığından vulvovajinal kandidozun gerçek insidansı bilinmemektedir. Vulvovajinal kandidozda olguların %70-90’ında etken Candida albicans’dır, ancak son yıllarda albicans dışı Candida türlerinde, özellikle de C.glabrata enfeksiyonlarında artış dikkati çekmektedir. Azol ilaç tedavisine azalmış duyarlılığı nedeniyle C.glabrata enfeksiyonlarının klinik önemi artmış olup epidemiyoloji ve popülasyonuna ilişkin bilgiler sınırlıdır. Bu çalışmada, Çukurova Bölgesinde vajinal örneklerden izole edilen C.glabrata izolatlarının mikrosatellit göstergeler ile genotiplendirilmesi, antifungal duyarlılık profilinin araştırılması ve fenotipik azol direncine neden olabilen moleküler mekanizmaların belirlenmesi amaçlanmıştır. Çalışmaya, akut (n= 11) ve rekürren (n= 14) vulvovajinal kandidoz tanılı olgular ile vajinit bulgusu olmayan kontrol grubundan (n= 9) izole edilen 34 vajinal C.glabrata suşu ve referans C.glabrata CBS 138 (ATCC 2001) suşu olmak üzere birbirleriyle ilişkisiz toplam 35 C.glabrata suşu dahil edilmiştir. Bu izolatlar, üç mikrosatellit göstergenin (RPM2, MTI ve Cg6), değişken sayıdaki uç tekrarlarındaki farklılıklarına dayalı, çoklu lokus gösterge analizi (Multiple-locus variable number tandem repeat analysis) ile genotiplendirilmiştir. Mikrosatellit gösterge analizi, RPM2, MTI ve Cg6 mikrosatellitlerinin PCR amplifikasyonu ve elde edilen ürünlerin kapiller elektroforezi ile yapılan fragment uzunluk analizi ile gerçekleştirilmiştir. Her bir suş için, bir gen (CgERG11) ve dört lokus (CgPDR1, NTM1, TRP1 ve URA3)’un DNA dizi analizleri yapılmış ve antifungal direnç ile ilişkili olabilecek mutasyonlar araştırılmıştır. CLSI M27-A3 belgesine göre 13 antifungal ilaç ve borik asidin in vitro duyarlılık profili belirlenmiş ve fenotipik ilaç direnci ile genotip ve belirlenen mutasyonlar arasındaki olası ilişki sorgulanmıştır. Çalışmamızda, C.glabrata CBS 138 suşu tüm antifungal ilaçlara duyarlı bulunmuş; 34 vajinal C.glabrata izolatından 1 (%2.9)’i flukonazol, 13 (%38.2)’ü itrakonazol ve 3 (%8.8)’ü vorikonazole doza bağlı duyarlı olarak saptanmış; bu antifungallere karşı dirençli izolata rastlanmamıştır. Klotrimazol direnci ise yalnızca 3 (%8.8) suşta izlenmiş; ancak genotip ve fenotipik direnç arasında ilişki olmadığı belirlenmiştir (p> 0.05). Mikrosatellit gösterge analizine göre 13 farklı genotip saptanmış ve yöntemin ayırt etme gücü yüksek (DP= 0.877) bulunmuştur. Sonuç olarak, C.glabrata izolatlarının genotiplendirmesinde mikrosatellit gösterge analizinin hızlı ve uygulanabilir bir yöntem olduğu, ancak ayırt etme gücünün yüksek olmakla birlikte ideal olmadığı belirlenmiştir. Fenotipik direnç testi ile mutasyon arasındaki ilişkinin doğrulanması için daha geniş örnek hacmine sahip, ileri çalışmaların yapılması gerektiği düşünülmüştür.Vulvovaginal candidosis is the second most common cause of vaginitis (17-39%) after bacterial vaginosis (22-50%). Since the diagnosis of vulvovaginal candidosis mainly depends on clinical findings without mycologic confirmatory tests and treated empirically, the actual incidence rate of vulvovaginal candidosis is unknown. Approximately 70-90% of vulvovaginal candidosis cases are caused by Candida albicans, however the increasing incidence of C.glabrata infections and its reduced susceptibility to azole drug therapy have generated increasing attention. The epidemiology and population structure of vulvovaginal candidosis due to C.glabrata are poorly characterized. This study was aimed to genotype the C.glabrata strains isolated from vaginal samples in Cukurova region, Turkey by microsatellite markers, to investigate the antifungal susceptibility profiles of the strains and to determine the molecular mechanisms leading to phenotypical azole resistance. A total of 34 unrelated vaginal C.glabrata strains isolated from patients with acute (n= 11) and recurrent (n= 14) vulvovaginal candidosis, control group (n= 9) without vaginitis symptoms, and a reference strain of C.glabrata CBS 138 (ATCC 2001) were included in the study. These isolates were genotyped using multiple-locus variable number tandem repeat analysis of three microsatellite markers (RPM2, MTI, and Cg6). Analysis of microsatellite markers was performed by fragment size determination of RPM2, MTI, and Cg6 PCR products through capillary electrophoresis. For each of the evaluated strains, DNA sequence analysis was performed for one gene (CgERG11) and four loci (CgPDR1, NTM1, TRP1, and URA3) to detect mutations possibly associated with antifungal resistance in each strain. In vitro susceptibility profiles of the strains to 13 antifungals and boric acid were determined according to CLSI document M27-A3 to investigate possible relationships between detected mutations and phenotypic resistance. C.glabrata CBS 138 strain was found to be susceptible to all the antifungals tested, while one of (%2.9) 34 vaginal C.glabrata isolates was found to be dose-dependent susceptible to fluconazole, 13 (38.2%) to itraconazole and 3 (8.8%) to voriconazole. No resistant strain were detected in the study population. Only three isolates were found to be resistant to clotrimazole (8.8%), however no relationship was identified between the genotypes and phenotypic resistance (p> 0.05). Thirteen genotypes were detected by microsatellite marker analysis, with high discrimination power (DP= 0.877). As a result, microsatellite marker analysis was validated as a rapid, reliable method for genotyping C.glabrata strains with good, but not optimal discriminatory power. Further studies examining larger numbers of isolates are needed to verify possible relationships between mutations and phenotypic resistance