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Hydatid cyst disease is a parasitic infection caused by Echinococcus granulosus and poses a serious health problem in endemic areas, including our country. Hydatid disease mostly affects the liver and lung, although involvements in many parts of the body have been reported in the literature. Isolated soft tissue involvement is very rare. We present an isolated hydatid disease case which affected the gluteal region of the body.

Objective: Trichomonas vaginalis is a protozoon that causes trichomoniasis which is characterised by a foamy yellowish odorous discharge and superficial defects and necrotic ulcers in vaginal mucosa. Trichomoniasis is transmitted from human to human by sexual contact and can be seen in almost every part of the world. The aim of this study was to determine the incidence of Trichomonas vaginalis in 18-45 years age group women with vaginal discharge complaints who applied to the Gynaecology Outpatient Clinic of Konya Social Insurance Instution Hospital during September 1-December 15 2003., Methods: Samples were taken from posterior fornix of the vagina with the aid of a speculum and sterile cotton swabs. All the samples were examined by wet mount preparations, Gram and Giemsa staining method under the light microscope., Results: Of seventy samples 6 (9%) were positive for Trichomonas vaginalis, 9 (13%) for Gardnerella vaginalis, one for Mobiluncus spp. and 11 (16%) for Candida spp., Conclusion: It is possible to say that, in spite of a definite diagnosis of trichomoniasis made by cultivation method, examining the vaginal smear by direct microscope also has an important role in the diagnosis of infection. Direct microscopic examination will help in deciding whether to begin the treatment of trichomoniasis.

Tuberculosis (TB) which is still one of the important infectious diseases in the world as well as Turkey, results in high morbidity and mortality. Clinical mycobacteriology laboratories have crucial roles in the identification, typing and susceptibility testing of Mycobacterium tuberculosis. The aims of this study were the investigation of the isolation rate of M.tuberculosis complex (MTC) from the clinical specimens of TB-suspected patients and to compare identification of mycobacteria isolated from solid and/or liquid media by using BACTEC NAP and immunochromatographic TB Ag MPT64 rapid test. A total of 1670 patients who were admitted to outpatients clinics of our hospital and prediagnosed as TB, have been included in the study. All the patients were anti-HIV seronegative. NALC-NaOH method were used for decontamination/ homogenization, and preparations from samples were stained with Erlich-Ziehl-Neelsen method to detect acid-resistant bacilli (ARB) in direct microscopy. All of the samples were inoculated into BACTEC™ MGIT-960 (Becton Dickinson, USA) and Löwenstein-Jensen (LJ) media for cultivation and incubated at 37°C for 6-8 weeks. Mycobacteria that were grown in the media have been identified by BACTEC™ NAP (Becton Dickinson, USA) and TB Ag MPT64 rapid test (SD Bioline Ag MPT64 Rapid™; Standard Diagnostics, Korea). The culture positivity in the samples of TB-suspected patients was found to be 3.7% (63/1670) with LJ and/or MGIT-960 methods, whereas ARB positivity rate was 1.6% (28/1670). Fifty-three (84%) out of culture positive 63 samples have been identified as MTC by BACTEC NAP test, while 61 (97%) were found as MTC by TB MPT64 test. Considering BACTEC NAP test as the reference method, TB MPT64 test identified all the MTC strains correctly (sensitivity: 100%), however the false positivity rate was estimated as 12.7% (specificity: 87%). Of 53 MTC positive samples, 36 were sputum, four were bronchoalveolar lavage, four were urine, three were gastric fluid, three were pleural fluid, and one of each were abscess, peritoneal fluid and cerebrospinal fluid samples. ARB positivity rate was detected as 41.5% (22/53) among MTC culture positive samples. Of the patients who were infected with MTC, 72% (38/53) were male and 98% (52/53) were adults (age range: 20-85 years). Our data indicating 3.1% (53/1670) isolation rate of MTC from TB-suspected patients in our region were in concordance with the other results reported from Turkey. In conclusion, immunochromatographic TB Ag MPT64 test which seemed to be useful for the rapid identification of mycobacteria grown on solid and/or liquid, was practical to perform and had high sensitivity, however further larger-scaled studies are needed to support our data in our country.

Human parvovirus B19 is a small, non-enveloped, icosahedral symmetric, single-stranded DNA virus that can cause a number of diseases, notably erythema infectiosum in children and aplastic crisis in patients with chronic hemolytic disorders. There have been limited data on the epidemiological pattern of parvovirus B19 infection in Turkey. The objective of this study was to investigate the seroprevalence of parvovirus B19 in Konya province (Central Anatolia), Turkey. Parvovirus B19 IgG antibodies were investigated by a commercial ELISA kit (RIDASCREEN, R-Biopharm AG, Germany) in 631 adults (age range: 18-> 60 years) and 542 children (age range: 0-17 years). The overall prevalence of parvovirus B19 IgG antibodies was 28.9%. The rate of parvovirus B19 IgG positivity was 20.7% (112/542) in the 0-17 years age group and was 36% (227/631) in the adult population. No significant difference in seropositivity rates were detected in terms of sex in children and adult group (p>0.05 in both groups). The rates of parvovirus B19 IgG seropositivity were 15.8% in 0-4 years age group, 16% in 5-9 years, 24.2% in 10-14 years, 40.9% in 15-19 years, 34.7% in 20-29 years, 35.5% in 30-39 years, 32.2% in 40-49 years, 37.5% in 50-59 years and 53.8% in > 60 years age group. The seropositivity rates in 0-4 and 5-9 years age groups were lower than the other age groups and the difference was statistically significant (p< 0.05). To determine the prevalence of parvovirus B19 in different age groups in different geographical areas is necessary since this will provide important information about the epidemiology of such infections.

Routine isolation, identification and susceptibility testing of anaerobic bacteria present several difficulties leading to defects in the determination of local susceptibility patterns which will guide empirical treatment protocols. This study was carried out to identify the anaerobic bacteria isolated from various clinical materials obtained from the suspected patients with anaerobic infection and to determine the antibiotic susceptibilities against several antibiotics. One hundred clinical specimens (36 blood, 31 abscess, 12 peritoneal fluid, 7 joint fluid, 7 pleural fluid, 3 biopsies, 3 cerebrospinal fluids and 1 surgical wound) that were examined in our laboratory during March 20-October 30 2007, were included in the study. The specimens were collected and transported under anaerobic conditions and inoculated to conventional aerobic media and to Wilkins Chalgren agar, Schaedler agar and chopped-meat broth for anaerobic isolation. Isolated anaerobic bacteria were identified with API 20A panels (Bio-Merieux, France) via conventional methods and by the help of AN-IDENT Discs (Oxoid, England). Penicillin G, clindamycin, cefoxitin, metronidazole, piperacillin/tazobactam and imipenem susceptibility tests were performed with E- test method. Twenty two anaerobic bacteria were isolated from 14 clinical specimens; 7 of the specimens yielding the growth of more than one type of anaerobic bacteria and 8 specimens yielding both anaerobic and facultative anaerobic bacterial (4 Escherichia coli and 4 Enterococcus spp.) growth. Anaerobic bacteria were isolated in 89 abscess and in 6 peritoneal fluid specimens. The distribution of the anaerobic bacteria identified among these specimens were as follows: Bacteroides fragilis (n = 6), Bacteroides spp. other than B.fragilis (n = 4), Clostridium spp. (n = 2), Fusobacterium necrophorum/nucleatum (n = 1), Prevotella intermedia/disiens (n = 1), Peptococcus niger (n = 2), Peptostreptococcus spp. (n = 5), and Lactobacillus acidophilus/lenseii (n = 1). Beta-lactamase activity was detected only in 2 of the 6 B. fragilis isolates. All of the isolates were susceptible to imipenem and piperacillin/tazobactam. The highest rate of resistance was detected against penicillin G (9/22; 41%). While anaerobic gram-positive cocci (n = 7) were found to be sensitive to all antibiotics, the rate of resistance among anaerobic gram-negative bacilli were 75% (9/12) to penicillin, 33.3% (4/12) to clindamycin, 8.3% (1/12) to metronidazole. Among anaerobic gram-positive bacilli (n = 3), 2 were resistant to metronidazole, one to clindamycin and one to cefoxitin. The results of this first anaerobic antimicrobial susceptibility testing study performed at Konya area in Turkey revealed that penicillin was not appropriate in empirical treatment of anaerobic infections, clindamycin susceptibility should be tested before use, metronidazole and cefoxitin could be used in empirical treatment and imipenem and piperacillin/tazobactam should be saved for the treatment of complicated infections and infections caused by resistant bacteria.

Helicobacter pylori infections which are common worldwide may be a risk factor for gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphomas. For the detection of H. pylori, invasive methods such as culture, histopathology and rapid urease tests which require endoscopy and gastric biopsy specimen and non-invasive methods (not requiring endoscopy) such as urea breath test, stool antigen test (H. pylori stool antigen; HpSA) and serology are used. The aim of this study was to investigate the presence of H. pylori in patients with dyspeptic complaints, by rapid urease test, HpSA test, culture and histopathology and to evaluate the diagnostic performance of HpSA test. A total of 103 dyspeptic patients who were admitted to Selcuk University Meram Medical Faculty Gastroenterology Clinic and undergone gastroduodenal endoscopy between January 2005 and December 2006, were included to the study. All the specimens were cultivated, however, urease activity was tested in 98 of the patients, histopathological examination in 76 and HpSA test in 86 of the patients. H. pylori was isolated in 38.8% (40/103) of the specimens by culture. H. pylori was positive in 38.2% (29/76) of the specimens by histopathology, in 86.7% (85/98) by urease test, and in 44.2% (38/86) by HpSA test. The sensitivity and specificity values of the tests when culture was taken as the gold standard, were; 97.5% and 20.7% for urease test, 75% and 82.6% for HpSA test and 72.5% and 100% for histopathology, respectively. In conclusion, HpSA method could be applied as a screening test for H. pylori diagnosis in case endoscopy could not be performed. However, if invasive methods were to be performed, the diagnosis should be confirmed by a more sensitive and specific test such as culture and histopathology.

Rabies is still an important public health problem in developing countries. Vaccination against rabies should be initiated as soon as possible following the suspicious bite. It is not yet clear whether previously vaccinated people should be re-vaccinated in case of re-exposure to rabies virus. In this study it is aimed to determine the antibody titer in sera of vaccinated people and also to evaluate the relation between the antibody titer and number of vaccination. The study group consisted of 186 persons (60 female, 126 male) aged between 2-90 years (mean: 35.7 years) and who were admitted to Manisa State Hospital Rabies Follow-up Center, Turkey. Hundred and thirty five of the cases were vaccinated according to the programmes advised by WHO's reference protocol for post-exposure rabies vaccination. However, vaccination was discontinued for 51 of the cases since the follow-up of the suspicious animal revealed that it was not rabid. Five-dose vaccination programme (on days 0, 3, 7, 14, and 30) was applied to 20 cases and four-dose programme (on days 0, 2, 7, 21) was applied to 115 cases. HDCV vaccine was applied as intramuscular injection and after 3-36 months following vaccination, rabies specific neutralizing IgG antibody titers were determined by using a commercial ELISA kit (Platelia Rabies II, BioRad, France). While the titer of IgG antibodies were within the protective limits (positive, > or = 0.5 IU/ml) in 116 (62.4%) of the 186 cases who were given two or more doses of HDCV, the titer was below the protective level (negative) in 70 (37.6%) of the cases. Although the rates of IgG positivity in two and three dose vaccine applied group (54.5% and 55.1%, respectively) were lower than the rates in four and five dose applied group (64.3% and 70%, respectively), the difference was not statistically significant (p> 0.05). These results denoted that the rate of protective antibody positivity was low (70%) even in full programme vaccinated cases and this might be attributed to age of the person, the length of time after vaccination, number of vaccinations and storage/transport condition of the vaccine. Thus in case of reexposure of vaccinated people to rabies virus, it is recommended to check the anti-rabies antibody titers if possible or to re-vaccinate those people with a history of prior vaccination exceeding one year since there is high probability of low level of protective antibodies.

Computers have been commonly used in daily life and at hospitals by medical staff. This study was carried out to search the microbial colonization of computer keyboards and mice used inside and outside hospital environments. Keyboards and mice samples from a total of 398 computers were included to the study, in which 38 were used by doctors and nurses in the hospital clinics (Group 1); 32 by the medical faculty students (Group 2), and 328 by university students (Group 3) in the computer laboratories of Selcuk University, Konya (located at middle Anatolia). Of the computers, 96.7% (n:385) have been found to be colonized by coagulase-negative staphylococci (CONS), 13.1% (n:52) by gram-positive spore-forming bacilli and 8.8% (n:35) by corynebacteria; followed by Candida spp. (4.2%), gram-negative bacilli (1.7%) [Acinetobacter spp. (n:4), Pseudomonas sp. (n:l), Klebsiella sp. (n:l), E. coli (n:1)], Staphylococcus aureus (1.5%), and molds (Penicillium, Aspergillus; 1.2%). The isolation rates of CoNS were similar between the groups (94,7%, 93.7%, and 97.2%, respectively). However it was noted that all of the gram-negative bacterial isolates (7/38; 18.4%) were from the samples collected from hospital computers (Group 1). Susceptibility rates of CoNS isolates to cefoxitin were detected as 26.2% in Group 1, 79.2% in Group 2, and 91.3% in Group 3. Five out of six S. aureus strains were found susceptible to cefoxitin, except one isolated from a sample of Group 1. Linezolid resistance in both CoNS and S. aureus isolates were not determined in any groups. As a result, according to the data obtained from this study as well as from the other foreign studies, the computer keyboards and mice which are widely used in the hospital settings, are being the source of potential cross contamination in the development of nosocomial infections. Therefore the computers should be cleaned properly frequently and hand washing procedures and disinfection rules should be obeyed after the use of computers before handling the patients.