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Data consisting of millions of cases cannot still explain the immunopathogenesis mechanism between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and host cell for ongoing coronavirus disease 2019 (COVID-19) pandemics. Epidemiological studies among different populations suggested different impacts of ABO and Rh antibodies on the COVID-19 susceptibility. Thus, the ABO blood group and the SARS-CoV-2 infection paradox remain unclear. Therefore, the present retrospective case–control study aimed to investigate the possible association between ABO blood groups and Rh blood types on SARS-CoV-2 infection in the Turkish Cypriot population. A total of 18,639 Turkish Cypriot subjects (297 SARS-CoV-2 COVID-19 patients and 18,342 healthy) were included in this study. Personal and clinical characteristics including age, gender, SARS-CoV-2 infection status, the ABO blood group and Rh blood types were evaluated and compared between two groups. As a result, ABO blood group was shown to be associated with a higher risk of SARS-CoV-2 infection as well as with male sex (p = 0.018). There was no association between Rh blood type and COVID-19. Overall, this study is the first largest sample group study to show the distribution of ABO blood group and Rh blood types in the healthy Turkish Cypriot population. Based on the current evidence, there are insufficient data to guide public health policies regarding COVID-19 pathogenesis.

Aim: SARS-CoV-2 variants of concern (VOCs) carry signature mutations particularly in the spike protein. Most VOCs lineages that carry N501Y substitution have been reported to evade viral diagnostic tests and have impact on vaccine effectiveness. Therefore, monitoring the circulating variants represents a major requirement for a public health response worldwide. We aimed to investigate the prevalence of N501Y bearing SARS-CoV-2 samples in Northern Cyprus. Materials & methods: Reverse transcription quantitative PCR technique was used to identify N501Y mutation from 658 samples. Results: Our results indicate that the proportion of N501Y-bearing lineages increased significantly from January through May 2021 (45.2–75.5%) in the region. Conclusion: These results indicate that VOCs are dominant lineages in the country and highlight an alarming situation which require strict governmental measures to minimize COVID-19 morbidity and mortality.

Amaç: Kan dolaşımı enfeksiyonları (KDE), morbidite ve mortalitenin en önemli nedeni sayılmaktadır. Bu çalışmada, kan kültürlerinde üreyen mikroorganizmaların dağılımını ve antimikrobiyal direnç oranlarını incelemek amaçlanmıştır.Yöntem: Yakın Doğu Üniversitesi (YDÜ) Hastanesi, Mikrobiyoloji Laboratuvarı’na Ocak 2016-Aralık 2020 tarihleri arasında gönderilen 7.866 kan kültüründen izole edilen mikroorganizmalar retrospektif olarak değerlendirmeye alınmıştır. Kan kültür şişeleri BACTEC 9120 otomatize sisteminde inkübe edilmiştir. İnkübasyon sırasında pozitif sinyal elde edilmesi halinde, steril enjektörle kan kültür şişelerinin içerisinden örnek alınarak Eosin-Methylene Blue (EMB) ve %5 koyun kanlı agarlara ekimleri yapıldı. Ekimi yapılan kültürler 24-48 saat süresince 35°C’de etüvde inkübasyona bırakıldı. Üreme saptanan kültürlerdeki mikroorganizmaların identifikasyon ve antibiyotik duyarlılık testleri (ADT) için VİTEK 2 (Biomerieux) kompakt otomatize sitemi kullanıldı.Bulgular: Kan kültürlerinin 691 (%8.8)’inde üreme saptanmıştır. İzole edilen mikroorganizmaların 392 (%56.7)’sini gram negatif bakteriler, 295 (%42.7)’ini gram pozitif bakteriler ve 4 (%0.6)’ünü ise Candida türleri oluşturmaktadır. En sık izole edilen bakteriler sırasıyla; Koagülaz negatif stafilokoklar (KNS) (%21.1), E. coli (%15.2), K. pneumoniae (%11.9), Staphylococccus aureus (%11.4) idi. E. coli dağılımına bakıldığı zaman GSBL oranı 2020 yılında artış göstermiştir fakat bunun istatistiksel olarak anlamlı olmadığı anlaşılmıştır (p=0.188). GSBL pozitif K. pneumoniae türleri ise yıllar içerisinde anlamlı derecede artış göstermiş ve 2019 yılında en yüksek (%69.6) seviyeye ulaşmıştır. Pseudomonas aeruginosa için ÇİD (çoklu ilaç dirençli) oranı %13 olarak belirlenmiştir. Acinetobacter baumannii için MDR oranı ise %97 olarak bulunmuştur. Hastalarımız arasındaki metisilin dirençli Staphylococccus aureus (MRSA) oranı %30.4’dür.Sonuç: KDE’dan izole edilen mikroorganizmaların ve duyarlılıklarının en kısa sürede belirlenmesi kritik öneme sahiptir. Ayrıca, aktif sürveyans sistemleri KDE’nın yönetimine yardımcı olmaktadır., Objective: Bloodstream infections (BSI) are considered to be the most important cause of morbidity and mortality. The main purpose of this study is to examine the distribution of microorganisms in blood cultures and the rates of antimicrobial resistance.Method: Microorganisms isolated from 7.866 blood cultures which were sent to our laboratory between January 2016-December 2020 were retrospectively evaluated. Blood culture bottles were incubated in BACTEC 9120 system. Blood samples were taken from the bottles with a sterile syringe and cultured on Eosin-Methylene Blue (EMB) and 5% sheep blood agars if there was a positive signal. The cultivated cultures were left to incubate at 35°C for 24-48 hours. VITEK 2 compact automated system was used for identification and antibiotic susceptibility tests (AST).Results: Reproduction was detected in 691 (8.8%) of blood cultures. There were 56.7% gram-negative, 42.7% gram-positive bacteria and 0.6% Candida species. The most common bacteria isolated are; coagulase negative staphylococci (CNS) (21.1%), Escherichia coli (15.2%), Klebsiella pneumoniae (11.9%) and Staphylococcus aureus (11.4%). The rate of ESBL-Escherichia coli increased in 2020, but this was not statistically significant (p=0.188). ESBL-Klebsiella pneumoniae species showed a significant increase over the years and reached the highest level (69.6%) in 2019. MDR (multi drug resistance) rate for Pseudomonas aeruginosa was determined as 13%. MDR rate for Acinetobacter baumannii was determined as 97%. The rate of methicillin resistant Staphylococcus aureus among patients is 30.4%. Conclusion: It is critical to determine microorganisms and their antibiotic susceptibilities as soon as possible in BSI. Active surveillance systems help manage the BSI.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in December 2019, and shortly after pandemic has been declared by the World Health Organization (WHO) due to its unstoppable global spread. Considerable amount of effort has beenput around the World in order to develop a safe and effective vaccine against SARS-CoV-2. Inactivated and RNA vaccines have already passed phase three studies showing sufficient efficacy and safety, respectively. Nowadays, there is a noticeable dominance of SARS-CoV-2 variants with various mutations over the wild type SARS-CoV-2. However, there is no report showing the efficacy of these vaccines on these variants. This case study describes a thirty-eight-year-old male reported to be infected with SARS-CoV-2 alpha variant following two doses of inactive CoronaVac administration with a protective level of SARS-CoV-2 specific antibodies. The variant analysis of the virus reported to be positive for N501Y mutation.This is the first case in the literature demonstrating that inactive SARS-CoV-2 vaccine might have a lower efficacy on alpha variant.

Background: Over the past 20 years, studies have indicated that the increasing spread of methicillinresistant Staphylococcus aureus (MRSA) demonstrates the need for adequate information about their epidemiology. This study was conducted in order to investigate the resistance rate of MRSA which were isolated from the Near East University (NEU) Hospital, North Cyprus. Methods: MRSA was isolated and identified by using selective media and the Phoenix BD 100 system (software version 6.01A) was used for antimicrobial susceptibility testing and identification. The antimicrobial susceptibility results were determined according to the Clinical and Laboratory Standarts Institute (CLSI) and the resistance rates of MRSA isolates to antibiotics were examined retrospectively. Results: The highest number of samples were from the departments of chest disease (24%) followed by dermatology (21.3%) and cardiology (18.7%). Out of 75 MRSA strains,; 29.7% from blood, 25.3% from wound, 14.7% from nasal swabs, 10.7% from aspiration fluids, 9.3% from sputum, 6.7% were from urine, 4.0% from IV catheters culture samples. All strains of MRSA were 94.7% sensitive to vancomycin and teicoplanin. Conclusions: The obtained results revealed that preventative measures should be implemented in order to minimize the bacterial resistance to antibiotics. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 101-104

Antibiotic resistance is becoming one of the threats to global health. This crisis has been attributed to the over-the-counter and overuse of antibiotics leading bacteria to gain the ability to resist and survive even in the presence of antimicrobial agents. Escherichia coli (E. coli) is one of the major gram-negative bacteria that are the representative indicators of antibiotic resistance. One of the mechanisms of gaining antibiotic resistance is the ability of E. coli to gain the production of extended-spectrum beta-lactamases (ESBL). In this study, Near East University Hospital data from 2016 to 2019 were used to study the dynamics of ESBL-producing ( ESBL + {\text{ESBL}}^{+} ) and non-ESBL-producing ( ESBL − {\text{ESBL}}^{-} ) E. coli infections by using a mathematical model. In our study, the aim was to evaluate the distribution of infections caused by resistant E. coli strains in later years and to increase the success of treatment in patients infected with E. coli by reducing the problem of antibiotic resistance. By using the mathematical model and data of the patients, basic reproduction number (R 0) values were calculated to study epidemiologic dynamics of the disease. The R 0 E − {R}_{0}^{{E}^{-}} and R 0 E + {R}_{0}^{{E}^{+}} values for ESBL − {\text{ESBL}}^{-} and ESBL + {\text{ ESBL}}^{+}\text{ } E. coli infections were calculated, respectively. According to the model and the data used within the study, it was calculated that R 0 E − {R}_{0}^{{E}^{-}} to be 1,266,403 and R 0 E + {R}_{0}^{{E}^{+}} to be 2,096,747. Since the values for R 0 E − {R}_{0}^{{E}^{-}} and R 0 E + {R}_{0}^{{E}^{+}} were equal or greater than 1, this suggests that currently the ESBL − \hspace{.25em}{\text{ESBL}}^{-} and ESBL + {\text{ ESBL}}^{+}\text{ } E. coli infections are in epidemic character for Cyprus. Furthermore, when simulation analyses were carried out for the model, it was predicted that in 2042 the ESBL − {\text{ESBL}}^{-} and ESBL + {\text{ ESBL}}^{+} E. coli infection trends will equalize. After 2042, the ESBL − {\text{ESBL}}^{-}\text{ } E. coli infections will indicate a descending pattern whereas ESBL + {\text{ ESBL}}^{+}\text{ } E. coli infection will increase constantly.

Objective:This study aimed to investigate the distribution of three-year carbapenem resistance of Acinetobacter baumannii complex (ABC) in hospital infections isolated from the intensive care unit in the last three years.Materials and Methods:The patients who had ABC infection in the Intensive Care Unit of Near East University Hospital between 2016-2018 were included in this study. The data of the patients were investigated retrospectively from the digital records and the Infection Control Committee data. The initial infection report of the patients who had multiple ABC infections was included in the study. SPSS Statistics 23.0 program was used for statistical analysis.Results:A total of 92 patients were diagnosed with ABC infection during the study period, including 22 (23.9%) in 2016, 31 (33.7%) in 2017 and 39 (42.4%) in 2018. Fifty-six patients (60.9%) were male and 36 (39.1%) were female. The mean age of the patients was 61.61±17.43 years (range, 22-89 years). The most common isolates were from tracheal aspirate (28.3%, 26 patients), sputum 27.2%, 25 patients) and urine samples (23.9%, 22 patients). Carbapenem-resistant ABC infection was detected in 65 patients (70.7%) and carbapenemsensitive ABC infection was found in 27 patients (29.3%). There was a statistically significant increase in carbapenem-resistant ABC strains over the years (p

Enterobius vermicularis (pinworm) infectious disease is small in size and needs careful analysis. This disease is usually seen in children and causes serious damage if early signs are not detected. Enterobius vermicularis is one of the most common helminth infections in the world. Humans are the only natural host of this parasitic disease. living in crowded environments is a risk factor for transmission. In this study, the deep learning method was applied to the small-scale pinworm disease that could be overlooked with a bare eye examination. The deep learning method(ResU-Net and U-Net) is trained with 365 Images to have high accuracy detection of the infection. The method was tested with 56 Images and the highest achievement dice score was 0.95%. This work has a unique future based on a segmentation mask that produces immediate visualization. The method is superior to the existing models. The segmentation mask method produces less error compared with the classical methods and uses less human resources, time and cost.

Introduction: Mobile phones are dynamic source of microorganisms in households and professional settings. The aim was to determine the prevalence of bacterial contamination of the mobile phones, identify bacterial isolates, assess their antimicrobial susceptibility patterns and define the efficiency of using disinfectant. Methodology: This study included 233 dental students from Near East University, Faculty of Dentistry. Swab samples taken from mobile phones before and after disinfection were inoculated onto 5% sheep blood medium and eosin methylene blue medium and incubated aerobically at 37°C for 24-48 hours. Mold-growing mix cultures were sub-cultured on the sabouraud dextrose medium and allowed to grow at room temperature. Conventional microbiological techniques and VITEK 2 automated identification system were used for bacterial identification and antimicrobial susceptibility testing. Antibiotic susceptibility tests were verified by Kirby-Bauer disc diffusion technique according to the European Antimicrobial Susceptibility Test Committee criteria. Mold colonies were identified macroscopic and microscopically according to their phenotypic properties using lacto-phenol cotton blue stain. Results: Microbial contamination of mobile phones was 81% (120.953 cfu/ml) in swab samples taken without using alcohol-based wipes however, microbial contamination in swab samples taken after one-time disinfection was determined to be 21% (201 cfu/ml). The most common microorganisms isolated were coagulase negative Staphylococci (69%) and Aspergillus niger (13%). All of the isolated bacteria were susceptible to all antibiotics used. Conclusions: This study represents the first data on the rate of microbial contamination on mobile phones in Northern Cyprus and the efficiency of the use of alcohol to disinfect the mobile phones.

Objective Natural plant products are considered as a source of novel and effective compounds for the treatment of leishmaniasis. In this study, the in vitro activities of essential oils obtained from Origanum dubium (OD), Origanum majorana (OM), Salvia fruticosa (SF) and Laurus nobilis (LN) plants in Northern Cyprus were investigated against Leishmania tropica. Methods Leishmania tropica strain (MHOM/TR/2012/CBCL-LT) was obtained. RPMI-1640 was added to 96-well plates in 100 μL aliquots, 100 μg/mL essential oil was added to the first well of each row and serial 2-fold dilutions were performed. A promastigote suspension was pipetted into all wells, and the plates were incubated. The promastigotes were enumerated using a haemocytometer. Results OD essential oil was effective at killing all promastigotes at a minimum inhibitor height (MIC)=0.2 μg/mL and had high activity at the lowest concentrations. Both SF and LN oils had MIC=1.56 μg/mL and LD50=0.78 μg/mL. SF was observed to impair promastigote morphology at the lowest concentrations, while LN did not exert any effect at concentrations

Objective: Pseudomonas aeruginosa is among the most common nosocomial opportunistic pathogens capable of acquiring multi-drug resistance. Recent data on antibiotic resistance in Northern Cyprus is limited. We aimed evaluate antibiotic susceptibility profiles of P. aeruginosa strains isolated from clinical samples and contribute to the update of antibiotic use policies in the country. Methods: Total of 504 P. aeruginosa strains sent to Microbiology Laboratory from various clinics from September 2016 to October 2019 were retrospectively analyzed. Clinical samples were cultured on %5 sheep blood agar and eosin-methylene blue agar. BD Phoenix™ 100 (Becton Dickinson Co., Sparks, Maryland, USA) automated bacterial identification system and conventional antimicrobial susceptibility testing was used. Antimicrobial susceptibility was determined in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The distribution of P. aeruginosa isolates according to hospital services, sample types, admission types, age group, and antibiotic resistance rates were investigated. Results: P. aeruginosa was mostly isolated from urine (37.3%), deep tracheal aspirate (17.9%) and abscess/wound material (17.9%) samples. Strains were most commonly obtained from the intensive care clinics (35.9%). Infections were observed mainly in >65 age group (49.6%) and in-patients (70.8%) group. Antibiotic resistance rates were detected as 47.7% for aztreonam, 32% for cefepime, 26.3% for ceftazidime, 26.4% for imipenem, 25.6% for ciprofloxacin, 24.6% for meropenem, 19.7% for piperacillin-tazobactam, 13.5% for gentamicin, 12.2% for colistin and 5.3% for amikacin. Multi-drug resistant P. aeruginosa rate was 19.2%. When compared with 2010-2014, a substantial increase in rates of cefepime, ceftazidime, ciprofloxacin, piperacillin-tazobactam and carbapenem resistance was detected within the last three years. Conclusions: In this study, the highest resistance rates were detected against aztreonam and cefepime, and the highest susceptibility was observed for colistin and amikacin. These results may be used for empirical treatments, establishment of rational antibiotic use policies and prevention of emerging antibiotic resistance problem in Cyprus.

Malaria still remains to be a public health threat and one of the most important infectious diseases to get attention from World Health Organization. No domestic malaria cases have been reported on the island of Cyprus since 1948, as a result of successful elimination process. All of the malaria cases detected in recent years are imported cases. As known, hundreds of medicines are obtained from plants and traditional medicine are used in endemic places of malaria. The cause of malaria - Plasmodium parasites, are developing resistance to antimalarial drugs. Hence, research on plant extracts and essential oils have gained great interest in recent years to obtain new and safe agents/substances. In our study, it was aimed to investigate the in vivo antimalarial activities of essential oils obtained from Origanum dubium, Origanum majorana, Salvia fruticosa and Laurus nobilis plants which grows in Northern Cyprus against Plasmodium berghei - the rodent malaria agent. Plants were collected in appropriate seasons and were dried to obtain and analyze essential oils via Clevenger Apparatus system. L929 mouse fibroblast cell line and MTT [3-(4.5-dimethylthiazole-2-yl) -2.5-diphenyltetrazolium bromide] kit were used to determine the cytotoxic activities of the essential oils obtained. In our study, total of 36 mice (Balb/c) of 6 groups (6 mice in each group) were formed: chloroquine group (CG) (50 mg/kg) as malaria reference group, untreated control group (UTCG), O.dubium (OD) (20 mg/kg), O.majorana (OM) (20 mg/kg), S.fruticosa (SF) (20 mg/kg) and L.nobilis (LN) (20 mg/kg). The essential oils were given to mice infected with P.berghei strain orally on 0, 1, 2 and 3rd days (4 times in total). Blood was taken from the tail end of each mouse 24 hours after the last treatment and blood collection was continued every two days until the mice died. Withdrawn blood taken from the mice were prepared as a thin smear and stained with Giemsa. Then, parasitemia percentages in each smear were calculated. As a result of the cytotoxicity tests, cytotoxic activity was not found at 100 µg/ml (20 mg/kg) in all oils except OD essential oil. While the mice receiving chloroquine continued their lives with the disappearance of the parasite on the 6thday, the mice in the UTCG died on the 9th day. The parasitemia rate reached 35% in the OM group on the 23rd day, in the OD group on the 21st day and in the other groups (SF and LN) on the 14th day and the mice have died. In our study, the difference between the life span in all groups was found statistically significant (p≤ 0.001). As a result, the essential oils O.majorana (14 days increase according to UTCG) an endemic plant of Cyprus and O.dubium (12 days increase according to UTCG) which had an antimalarial effect, decreased parasitemia and increased the life span of mice more than two times, indicated that they could be a source for the acquisition of new antimalarial molecules.

Background Antibiotic-resistant Enterobacteriaceae in the gastrointestinal flora can lead to infections with limited therapeutic options. Also, the resistant bacteria can be transferred from colonized persons to others. The present study was conducted to search the fecal carriage rates of (i) Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL-E) and/or (ii) plasmid-mediated AmpC β-lactamase (pAmpC-E), (iii) ciprofloxacin-resistant Enterobacteriaceae (CIP-RE), and (iv) carbapenem-intermediate or -resistant Enterobacteriaceae (CIRE) in Northern Cyprus. Methods A total of 500 community-dwellers were recruited from consecutive admissions to the clinical laboratories of four hospitals. One rectal swab or stool sample was collected from each participant. A questionnaire was applied to evaluate possible risk factors associated with intestinal colonization of resistant bacteria. The samples were cultured on antibiotic containing media to screen for resistant bacteria colonization. The bacterial colonies that grew on the plates were subjected to further phenotypic tests to confirm the resistance. Results Of 500 volunteers, ESBL-E, pAmpC-E, CIP-RE and CIRE carriage were detected in 107 (21.4%), 15 (3.0%), 51 (10.2%) and six (1.2%) participants, respectively. Escherichia coli was the most commonly recovered species among Enterobacteriaceae isolates. A significant proportion of ESBL-producing E. coli isolates (n = 22/107; 20.6%) was found to be co-resistant to CIP (p = 0.000, OR 3.21, 95% CI 1.76–5.87). In this study, higher socioeconomic status (CIP-RE: p = 0.024, OR 1.96, 95% CI 1.09–3.53), presence of gastrointestinal symptoms (CIRE: p = 0.033; OR 6.79, 95% CI 1.34–34.39), antibiotic use (ESBL-E: p = 0.031; OR 1.67, 95% CI 1.04–2.67; and CIRE: p = 0.033; OR 6.40, 95% CI 1.16–35.39), and travelling abroad (pAmpC-E: p = 0.010; OR 4.12, 95% CI 1.45–11.66) were indentified as risk factors. Conclusion The study indicates that resistant Enterobacteriaceae isolates are carried by humans in the community. To prevent further spread of resistance, rational use of antibiotics should be encouraged, and antibiotic resistance should be carefully monitored in Northern Cyprus.

Objectives Antibiotic therapy is increasingly becoming difficult to treat Pseudomonas infections. Two multi-drug resistant, clinically derived Pseudomonas strains contained related transposons that are responsible for giving rise to resistance determinants. In this study we characterise these transposons. Methods Two clinical, multidrug resistant Pseudomonas isolates were obtained from a medical facility in Cyprus. The strains were identified as Pseudomonas putida C54 and Pseudomonas aeruginosa C69. DNA was extracted from both strains and sequenced. Transposons were identified, annotated and compared to DNA sequences in GenBank. Results Two related nested transposons, here, named Tn6608 (from P. putida C54) and Tn6609 (from P. aeruginosa C69) were characterised. The transposons are built on an ancestral Tn1403 base element (here named Tn1403A) that contains only the transposition module (tnpA and tnpR) and the associated cargo gene module (orfA, orfB, orfC and orfD) flanked by 38 bp IR. The nested transposons identified in this study have evolved via the acquisition of multiple transposons, adding multiple resistance genes to an ancestral transposon that originally lacked any resistance determinants. Conclusion Transposons related to Tn6608 and Tn6609 have evolved and are globally disseminated. Of particular interest is that most of these nested transposons are located within the same site in a genomic island providing alternative avenues for dissemination.

Malaria is still an infectious disease that causes high mortality in endemic regions. It is thought that it will maintain importance in the future, especially due to people travelling from African countries where malaria is endemic to its eradicated regions. Therefore, rapid and accurate diagnosis is a critical step in the effective treatment of malaria and reducing mortality rates. This paper provides a malaria diagnosis system using an artificial neural network approach with SURF (Speeded Up Robust Features) method that helps the clinicians to predict and locate infected cell with malaria on the sample thin blood smear image. The performance of the proposed neural network and local image feature extraction technique SURF were analyzed statistically and presented in this paper. The network was trained using only 45 infected thin blood smear images and was then tested with 200 (100 infected and 100 non-infected) unseen images. The experimental results showed that the proposed system identified the malaria parasite with 93% accuracy, 86% sensitivity and 100% specificity.

Objective In present times, malaria remains an infectious disease with a high mortality rate in some regions of the world. It is predicted to preserve its importance as a disease in the future because of the traveling human populations from malaria-endemic African countries into the regions where malaria has been eradicated. The objective of this study is to evaluate the increasing imported malaria cases in the Turkish Republic of Northern Cyprus. Methods In this study, we investigated 13 patients who were diagnosed with malaria between 2016 and 2019. We clinically evaluated all the cases. More importantly, we made the diagnosis of these patients by Giemsa-stained thin and thick blood smears, rapid malaria antigen tests, and genotyping (only for five patients) by real-time polymerase chain reaction. Additionally, we evaluated patients with malaria in terms of age, gender, and seasons. Results In the diagnosed malaria cases, 11 (84.4%) of them were male and 2 (15.6%) were female. There was no significance between malaria infection and gender (p=0.358). Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale infection were detected in ten patients (76.9%), two (15.4%) patients, and one (7.7%) patient, respectively. There was a significant increase (p=0.003) in the malaria cases in 2019 (n=9). The seasonal comparison revealed that malaria infections are most common in autumn (8/13, 61.5%). Conclusion Despite the eradication of malaria in Turkish Republic of Northern Cyprus, the rising number of recently imported cases increases the risk of emerging local cases. Malaria infection should be immediately suspected, particularly, in foreign patients who travel from the malaria-endemic region and present with symptoms such as fever and shivering if the laboratory findings especially detect thrombocytopenia.

Introduction: Quantitative analysis of Mycobacterium tuberculosis using microscope is very critical for diagnosing tuberculosis diseases. Microbiologist encounter several challenges which can lead to misdiagnosis. However, there are 3 main challenges: (1) The size of Mycobacterium tuberculosis is very small and difficult to identify as a result of low contrast background, heterogenous shape, irregular appearance and faint boundaries (2) Mycobacterium tuberculosis overlapped with each other making it difficult to conduct accurate diagnosis (3) Large amount of slide can be time consuming and tedious to microbiologist and which can lead to misinterpretations. Methodology: To solve these challenges and limitations, we proposed an automated-based detection method using pretrained AlexNet to trained the model in 3 sets of experiments A, B and C and adjust the protocols accordingly. We compared the detection of tuberculosis using AlexNet Models with the ground truth result provided by microbiologist and analyzed inconsistencies between network models and human. Results: 98.15 % accuracy, 96.77% sensitivity and 100% specificity for experiment A, 98.09% accuracy, 98.59% sensitivity and 97.67% specificity for experiment B and 98.73% testing accuracy, 98.59 sensitivity, 98.84% specificity ofr experiment C which sound robust and promising. Conclusions: The results indicated that network performance was successful with high accuracies, sensitivities and specificities and it can be used to support microbiologist for diagnosis of tuberculosis.

Aim: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has generated over 8 000 000 cases of the coronavirus disease 2019 (COVID-19) worldwide and has led to the implementation of strict measures in all countries. The aim of this study was to investigate the knowledge, attitude and implementation status of personal protective measures (PPMs) by ordinary citizens in Northern Cyprus and their access to personal protective equipment (PPE) during the COVID-19 outbreak.Subject and Methods: This was a cross-sectional study based on internet-based survey. A total of 406 participants were recruited between May 1 and 4, 2020 via authors’ networks to complete a questionnaire. Participants were asked to indicate how often they implemented the five PPMs recommended by the World Health Organization (WHO), their daily frequency of hand hygiene events, their COVID-19 knowledge as well as the availability of PPE in their hometown.Results: The prevalence of the five PPMs ranged from 65.0% to 95.6%, with the highest being hand hygiene and the lowest being avoiding touching the eyes, nose, and mouth. Hand hygiene events were recorded to be more than 10 per day in 47.3% of the participants. Gloves (86.2%), surgical masks (52.2%), and cloth face masks (47.3%) were the most commonly used PPE in public areas. The majority of the responders were aware of the incubation time (90.4%) and indirect route of viral transmission (89.7%), whereas knowledge of droplet (72.2%) and aerosol transmission (43.6%) were lower. Knowledge was gained mainly through social media and TV.Conclusion: Overall, citizens implemented protective measures effectively and were strictly coherent to government-induced curfew and self-isolation measurements with a high public awareness.

Bu çalışma, Mudurnu (Bolu) ilçesi Taşkesti kasabası fındık popülasyonu içerisinde verimli ve kaliteli genotiplerin araştırılması amacıyla 2015-2016 yıllarında yürütülmüştür. Bu amaçla, bölgede 35 farklı genotip belirlenmiş ve yörede yaygın olarak yetiştirilen Delisava, Yomra ve Karayağlı çeşitlerinden de veriler alınarak, genotiplerin verim ve kalite özellikleri çeşitlerle mukayeseli olarak iki yıl süre ile izlenmiştir. 2015 yılında 35 genotip için dal verimi 45.9 g (T-30) ile 775.9 g (T-19) arasında bulunmuştur. Delisava, Karayağlı ve Yomra çeşitlerinde dal verimi 376.1 g ile 529.1 g (Karayağlı-2) arasında tespit edilmiştir. 2016 yılında yalnızca sekiz genotipe ait dal verimi değerleri ölçülebilmiş olup, bu değerler 67.86 g (T-35) ile 297.2 g (T-32) aralığında değişmiştir. Aynı yıl, sadece Delisava-2 klonlarından ürün alınırken, dal verimi 513.2 g olarak kaydedilmiştir. Çotanaktaki meyve sayısı 2015 yılında genotiplerde 1.12 (T-25) ile 5.35 (T-1); Delisava, Karayağlı ve Yomra çeşitlerinde 1.91 ile 4.47 aralığında değişmiştir. 2016 yılında ise ürün veren 8 genotipte 1.25 (T-32) ile 3.63 (T-4) aralığında, Delisava-2 klonu için ise 2.10 olarak kaydedilmiştir. 2015 yılında, 35 genotipte meyve ağırlığı 0.94 g ile 2.39 g, Delisava, Karayağlı ve Yomra çeşitlerinde 1.42 g ile 2.18 g; iç oranı 35 genotipte %41.16 ile %58.53, Delisava, Karayağlı ve Yomra çeşitlerinde %47.29 ile %53.70; çotanaktaki meyve sayısı 35 genotipte 1.19 ile 5.35, Delisava, Karayağlı ve Yomra çeşitlerinde 1.91 ile 4.47 aralığında belirlenmiştir. 2016 yılında kabuklu meyve ağırlığı ürün alınabilen 8 genotipte 0.87-1.76 g, Delisava çeşidinde 2.13 g; iç oranı 8 genotipte %41.95-52.25, Delisava çeşidinde %56.67; çotanaktaki meyve sayısı 8 genotipte 1.25-3.63, Delisava çeşidinde 2.10 olarak tespit edilmiştir. Araştırma soncunda, şiddetli don yılı sonrası dal verimleri 400-500 g üzerinde olan genotipler ile, üst üste iki yıl ürün veren genotipler ve Delisava-2 klonu dikkat çekici bulunmakla beraber, bunlar üzerinde daha uzun süreli çalışmalar yapılması gerekmektedir., This study was carried ot in 2015-2016 with the aim of determining genotypes which has high yield and quality. In this prupose, 35 different genotypes were labeled and standart varieties, which is widely propagated in the region, Delisava, Yomra and Karayağlı were used for comparison. Genotypes were evaluated based on their branch yield. Branch yield was averagely determined based on three branches of ‘Ocak’. In 2015, while branch yield was ranging from 45.89 g (T-30) to 775.9 g (T-19), it was higher than 500 g for 3 genotypes, 400 g for 3 genotypes and 300 g for 14 genotypes. Branch yield was found between 376.1 g and 529.1 g for Delisava, Karayağlı and Yomra clones. In 2016, only eight genotypes were yielded and branch yield was between 67.86 g (T-35) ile 297.2 g (T-32) in them. In the same year only Delisava-2 clones were yielded and branch yield was 513.2 g. Number of fruits in cluster were between 1.12 (T-25) - 5.35 (T-1) in genotypes and it was 1.91 - 4.47 g in varieities in 2015. In the eight genotypes which were yielded in 2016 had 1.25 (T-32) - 3.63 (T-4) fruits per cluster, while Delisava-2 clone had 2.10. In 2015, the fruit weight in 35 genotypes was 0.94 g - 2.39 g, while Delisava, Karayağlı and Yomra varieties were 1.42 g - 2.18 g; the kernel ratio was 41.16% - 58.53% in 35 genotypes, and was 47.29% - 53.70% in Delisava, Karayağlı and Yomra cultivars; The number of fruits in the cluster was recorded between 1.19 - 5.35 in 35 genotypes, and between 1.91 - 4.47 in Delisava, Karayağlı and Yomra varieties. In 2016, shelled fruit weight was 0.87-1.76 g in genotypes and 2.13 g in Delisava variety while kernel raito was %41.95-52.25 in genotypes and was %56.67 in Delisava. The results of study suggested the genotypes yielded over 400 g branch-1 and Delisava-2 clone as promising for further studies.

Introduction: Acute tonsillopharyngitis is the most important infectious cause of hospital admission in pediatric age groups. The aim of this study was to investigate the prevalence of group A beta-hemolytic streptococci in patients prediagnosed with acute tonsillopharyngitis in a university hospital in Northern Cyprus and determine the effectiveness of Streptococcus rapid antigen test (SRAT) in diagnosis. Materials and Methods: Patients with acute tonsillopharyngitis prediagnosis and admitted to our hospital between September 1, 2015 and December 31, 2017 were retrospectively screened from physical and electronic records. Patients with a throat culture and/or SRAT result were included in the study. Culture method was used as the golden standard. Statistical analysis was performed with SPSS version 13.0 (SPSS Inc., Chicago, IL, USA) programme and p

Background: Patients undergoing dialysis treatment and hemodialysis are at risk of viral infections due to inadequate cellular immunity. Objectives: The aim of the study was to determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in hemodialysis (HD) centers in North Cyprus. Methods: The present study reviewed the health records of 140 patients in two dialysis units that represented all HD units in North Cyprus. Serological markers for HBV, HCV, and HIV were determined by the immunoenzymatic assay using commercial diagnostic kits (Architect i2000 SR, Abbott, USA). HCV RNA, HBV DNA, and HIV RNA were determined quantitatively using polymerase chain reaction (PCR). Results: One hundred forty HD patients were included in the study, consisting of 39.3% (n = 55) female and 60.7% (n = 85) male patients. Five (3.6%) patients were anti-HCV positive, one (0.7%) patient was HBsAg positive, and one (0.7%) was anti-HIV positive. Anti-HCV and HBsAg were negative in all of the patients according to the PCR results. There were no significant differences between males (1.2%) and females (7.3%) in terms of anti-HCV positivity (P = 0.078), HBsAg seropositivity (P = 0.607), and anti-HIV seropositivity (P = 0.607). Conclusions: The prevalence of HBV, HCV, and HIV infection in hemodialysis patients in North Cyprus is moderate to low. The main reason for the significantly lower rates compared to other areas could be effective protective measures and national vaccination.

Introduction: Brucellosis causes a necrotic and inflammatory infection in humans and animals, and is among the world's most common zoonotic diseases. The aim of this study was to determine the seroprevalence of Brucella antibodies and compare serological methods in Turkish Republic of North Cyprus, where animal husbandry is common. Materials and Methods: The study was conducted between December 2017 and February 2018 and included veterinarians (n=50), animal caregivers (n=109), butchers (n=65), and a control group of individuals who had no connection with animals (n=100). Serum samples from the participants were analyzed with serological techniques including Rose Bengal test (RBT), standard tube agglutination test (STA) and ELISA; IgG and IgM methods. The sensitivity and specificity of the methods used were estimated by considering ELISA (IgG and/or IgM) results as reference/golden standard. Results: Of 27 patients (8.3%) patients who had positive results from at least one of the serological tests, 21 (6.5%) had positive RBT, 15 (4.6%) had positive STA and 10 (3.1%) had positive ELISA (IgG and/or IgM). Six (28%) patients with negative RBT results were found to be positive in ELISA. Seventeen samples (80.9%) were RBT-positive but ELISA- negative. Conclusion: These data suggest that Brucella infection is at low rate in the Turkish Republic of North Cyprus. Laboratory diagnosis should be supported by tests such as seroconversion for low titers on STA, or tests such as ELISA. Only two cases were reported to the Ministry of Health Statistics Unit in 2013.

Background Antibiotic-resistant Enterobacteriaceae in the gastrointestinal flora can lead to infections with limited therapeutic options. Also, the resistant bacteria can be transferred from colonized persons to others. The present study was conducted to search the fecal carriage rates of (i) Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL-E) and/or (ii) plasmid-mediated AmpC β-lactamase (pAmpC-E), (iii) ciprofloxacin-resistant Enterobacteriaceae (CIP-RE), and (iv) carbapenem-intermediate or -resistant Enterobacteriaceae (CIRE) in Northern Cyprus. Methods A total of 500 community-dwellers were recruited from consecutive admissions to the clinical laboratories of four hospitals. One rectal swab or stool sample was collected from each participant. A questionnaire was applied to evaluate possible risk factors associated with intestinal colonization of resistant bacteria. The samples were cultured on antibiotic containing media to screen for resistant bacteria colonization. The bacterial colonies that grew on the plates were subjected to further phenotypic tests to confirm the resistance. Results Of 500 volunteers, ESBL-E, pAmpC-E, CIP-RE and CIRE carriage were detected in 107 (21.4%), 15 (3.0%), 51 (10.2%) and six (1.2%) participants, respectively. Escherichia coli was the most commonly recovered species among Enterobacteriaceae isolates. A significant proportion of ESBL-producing E. coli isolates (n = 22/107; 20.6%) was found to be co-resistant to CIP (p = 0.000, OR 3.21, 95% CI 1.76–5.87). In this study, higher socioeconomic status (CIP-RE: p = 0.024, OR 1.96, 95% CI 1.09–3.53), presence of gastrointestinal symptoms (CIRE: p = 0.033; OR 6.79, 95% CI 1.34–34.39), antibiotic use (ESBL-E: p = 0.031; OR 1.67, 95% CI 1.04–2.67; and CIRE: p = 0.033; OR 6.40, 95% CI 1.16–35.39), and travelling abroad (pAmpC-E: p = 0.010; OR 4.12, 95% CI 1.45–11.66) were indentified as risk factors. Conclusion The study indicates that resistant Enterobacteriaceae isolates are carried by humans in the community. To prevent further spread of resistance, rational use of antibiotics should be encouraged, and antibiotic resistance should be carefully monitored in Northern Cyprus.

Identification of hepatitis B virus (HBV) strains and understanding of molecular epidemiological characteristics are important for the effective surveillance of HBV infections. Genotype D is dominant in studies performed in Turkey but it is known that cases infected with genotypes A, E, G and H also exists. In contrast, there are no data regarding the molecular epidemiologic characteristics of the HBV in Northern Cyprus. The aim of this study was to determine the distribution of genotypes and subgenotypes of HBV among the people living, educating and working in Northern Cyprus. A total of 160 cases (1.2%) who were HBsAg seropositive out of 13.892 subjects admitted to Nicosia, Near East University Hospital microbiology laboratory for the routine control and to blood center for donor screening tests between November 2011 to September 2014, were included in the study. HBV-DNA levels in the HBsAg positive cases were detected by real-time polymerase chain reaction and genotypes/subgenotypes were determined by sequence analysis of the viral pol gene (reverse transcriptase [rt] region, between 80-250. aminoacids). Sixty samples (60/160, 37.5%) were excluded from sequencing analysis due to negative and/or very low (< 30 IU/ml) HBV-DNA levels, so 100 samples were included in sequence analysis. Ninety-six of those cases (13 female, 87 male; mean age: 35.51 ± 12.88 years) were anti-HBc IgG, 95 were anti-HBe and five were HBeAg positive, with a mean HBV-DNA level of 5.36 x 10(6) ± 3.58 x 10(7) IU/ml. As 32 (32%) samples yielded HBV-DNA level below the threshold of 1000 IU/ml, sequence analyses were unsuccesful, eventually 68 (68/160, 42.5%) samples could be phylogenetically analyzed. The distribution of HBV genotypes/subgenotypes were found as follows: 48 were (70.6%) D/D1; four were (5.9%) D/D2; one was (1.5%) D/D3, five were (7.4%) A/A1, two were (2.9%) A/A2 and eight were (11.8%) genotype E. Among the most frequent D1 strains, 60.4% (29/48) cases were from Turkish; single D/D3 strain from Benguela (Angola) and all eight genotype E strains were from Nigerian national cases. According to the data of this first study performed in TRNC on this subject, genotype D is dominant (53/68, 78%) in Northern Cyprus and consistent with the subgenotype distribution that is similar to Turkey and mediterranean basin. The prevalences of genotype A (7/68, 10.3%) and E (8/68, 11.8%) were also remarkable. In conclusion, although Northern Cyprus is an island country the heterogeneous distribution of HBV genotype/subgenotype may be contributed to the cosmopolitan characteristics of various populations from different countries who have come here for education, work or touristic purposes.

Detection of borderline and/or low positive anti-HCV results by enzyme immunoassay (EIA) leads to severe problems in routine laboratories and needs confirmation with nucleic acid amplification tests which can increase the cost. In EIA tests, if the ratio of sample to cut-off (S/Co) is ≥ 1, the sample is accepted as positive according to the manufacturers' instructions. Although over the last decade the application of S/Co values have also applied to HCV-RNA readings, the current study aims to determine whether the S/Co value is adequate and applicable for the anti-HCV EIA test, and to determine whether a correlation exists between HCV-RNA and HCV infections. A total of 658 cases (402 female, 256 male; mean age: 49.4 ± 17.0 years) who were found anti-HCV positive between January 2011-July 2013 were included in the study. Anti-HCV tests were performed by chemiluminescent EIA (Architect i2000SR, Abbott, USA and LiaisonXL Murex, DiaSorin, Italy) and HCV-RNA by real-time PCR (Cobas Ampliprep/Cobas TaqMan HCV, Roche, USA). The mean S/Co value of the cases was 7.3 ± 4.8 (range: 1.00-17.59) and mean HCV-RNA value was 2.3x105 ± 2.1x106 copies/ml. When the anti-HCV S/Co value of varying ranges was compared with HCV-RNA readings a particular trend was noted. In the anti-HCV S/Co values of 1.0-4.0; 4.1-7.0; 7.1-10.0; 10.1-13.0; 13.1-16.0 and ³16.1, HCV-RNA positivity rates were detected as 1.9%, 24.7%,37.1%, 46.7%, 56.4% and 75%, respectively. Statistical analysis indicated an intermediate positive correlation (r= 0.454) between anti-HCV ve HCV-RNA readings (p= 0.000). An adequate S/Co value was accepted as 5.0 based on the ROC analysis, and this value gave a performance confidence level of 95.6% when determining whether a patient is HCV positive. Based on the data of this study it became evident that further EIA testing is not required if the S/Co value is ≥ 5.0, however if the S/Co value is less than 5.0, then further clinical analysis and revaluation of the patient is required.