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Elizabethkingia anophelis was firstly isolated from the midgut of the Anopheles gambiae mosquito in 2011. After this year, it was isolated in some intensive care cases in Africa and Asia. This study, it was aimed to confirm the identification of E. anophelis in the blood of a pediatric patient.After the suspicious bacteria were grown on blood agar, MALDI-TOF MS and 16s rRNA gene sequencing methods were used to identify and an antibiotic susceptibility test was carried out by Vitek 2 Compact system according to the EUCAST. Finally, a phylogenetic tree was created based on the 16s rRNA gene region.The isolate was identified as E. anophelis by both methods. It was found to be resistant to all beta-lactam antibiotics and also susceptible to ciprofloxacin and levofloxacin. According to the 16S rRNA-based phylogenetic tree, our isolate clustered within a branch containing other E. anophelis.These findings will guide clinicians in choosing which antibiotic to choose if they encounter this agent. Also, the clinicians should be vigilant against this agent, as it is a newly emerging infectious agent in Turkey.

Objectives Aspergillus fumigatus causes several diseases in humans and azole resistance in A. fumigatus strains is an important issue. The aim of this multicentre epidemiological study was to investigate the prevalence of azole resistance in clinical and environmental A. fumigatus isolates in Turkey. Methods Twenty-one centres participated in this study from 1 May 2018 to 1 October 2019. One participant from each centre was asked to collect environmental and clinical A. fumigatus isolates. Azole resistance was screened for using EUCAST agar screening methodology (EUCAST E.DEF 10.1) and was confirmed by the EUCAST E.DEF 9.3 reference microdilution method. Isolates with a phenotypic resistance pattern were sequenced for the cyp51A gene and microsatellite genotyping was used to determine the genetic relationships between the resistant strains. Results In total, resistance was found in 1.3% of the strains that were isolated from environmental samples and 3.3% of the strains that were isolated from clinical samples. Mutations in the cyp51A gene were detected in 9 (47.4%) of the 19 azole-resistant isolates, all of which were found to be TR34/L98H mutations. Microsatellite genotyping clearly differentiated the strains with the TR34/L98H mutation in the cyp51A gene from the strains with no mutation in this gene. Conclusions The rate of observed azole resistance of A. fumigatus isolates was low in this study, but the fact that more than half of the examined strains had the wild-type cyp51A gene supports the idea that other mechanisms of resistance are gradually increasing., Bursa Uludag University Scientific Research Projects Commission [QUAP[T]-2015-5]; Ener Private Health Service Company, This work was partly supported by Bursa Uludag University Scientific Research Projects Commission (QUAP[T]-2015-5) and Ener Private Health Service Company.

Introduction: Stenotrophomonas maltophilia, a non-fermentative bacterium, predominantly causes opportunistic infections in immunocompromised individuals and those receiving long-term, large-dose, broad spectrum antimicrobial agents. It is inherently resistant to most of the available antimicrobial agents. Trimethoprim-sulfamethoxazole (TMP/SMX), ceftazidime (CAZ), and levofloxacin (LVX) are the drugs of choice used for the infection treatment. The study aims to investigate the presence of plasmid-mediated quinolone resistance determinants of QnrA, QnrB, QnrC, QnrD, QnrS, and OqxAB genes in S. maltophilia isolates. Materials and Methods: A total of 122 S. maltophilia isolates from various clinical specimens were tested in the study. The susceptibility of TMP/SMX and LVX was determined by disk diffusion method. The minimum inhibitory concentration value of CAZ was determined by the gradient diffusion test. Qnr (A, B, C, S, D) determinants and OqxAB were investigated using multiplex polymerase chain reaction. OqxA was investigated in the isolates and the presence of OqxB in OqxA-positive isolates. Results: Five (4%) of the S. maltophilia isolates were resistant to TMP/SMX. Levofloxacin and CAZ resistances were determined as 6.5% and 56.5%, respectively. QnrS was detected in two of the isolates, and OqxA gene was found in three isolates. However, these isolates were not OqxB positive. One of these three positive isolates has been previously found to be QnrS-positive. Conclusion: In our study, QnrS was detected in two and OqxA gene in three of the S. maltophilia isolates.

Candida tropicalis is the fourth leading cause of candidemia in Turkey. Although C. tropicalis isolates from 1997 to 2017 were characterized as fully susceptible to antifungals, the increasing global prevalence of azole-non-susceptible (ANS) C. tropicalis and the association between high fluconazole tolerance (HFT) and fluconazole therapeutic failure (FTF) prompted us to re-evaluate azole susceptibility of C. tropicalis in Turkey. in this study, 161 C. tropicalis blood isolates from seven clinical centers were identified by ITS rDNA sequencing, genotyped by multilocus microsatellite typing, and tested for susceptibility to five azoles, two echinocandins, and amphotericin B (AMB); antifungal resistance mechanisms were assessed by sequencing of ERG11 and FKS1 genes. the results indicated that C. tropicalis isolates, which belonged to 125 genotypes grouped into 11 clusters, were fully susceptible to echinocandins and AMB; however, 18.6% of them had the ANS phenotype but only two carried the ANS-conferring mutation (Y132F). HFT was recorded in 52 isolates, 10 of which were also ANS. Large proportions of patients infected with ANS and HFT isolates (89 and 40.7%, respectively) showed FTF. Patients infected with azole-susceptible or ANS isolates did not differ in mortality, which, however, was significantly lower for those infected with HFT isolates (P = 0.007). There were significant differences in mortality (P = 0.02), ANS (P = 0.012), and HFT (P = 0.007) among genotype clusters. the alarming increase in the prevalence of C. tropicalis blood isolates with ANS and HFT in Turkey and the notable FTF rate should be a matter of public health concern., Major National R&D Projects of the National Health Department [2018ZX10101003]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [31770161]; Shanghai Science and Technology CommitteeShanghai Science & Technology Committee [17DZ2272900, 14495800500]; Shanghai Municipal Commission of Health and Family Planning [2017ZZ01024-001]; Shanghai Sailing Program [19YF1448000]; Chinese Academy of Engineering [2019-XY-33], This work was supported by the Major National R&D Projects of the National Health Department (2018ZX10101003), National Natural Science Foundation of China (31770161), Shanghai Science and Technology Committee (17DZ2272900 and 14495800500), Shanghai Municipal Commission of Health and Family Planning (2017ZZ01024-001), Shanghai Sailing Program (19YF1448000), and the Chinese Academy of Engineering (2019-XY-33).

WOS: 000485661700047, PubMed: 30980958, Objectives: This study investigated the antifungal resistance rates of isolates from candidaemia patients in 12 tertiary-care centres in Turkey. Methods: A total of 1991 Candida spp. isolates from 12 centres isolated from 1997-2017 were included in the study. Species/species complex (SC) identification was performed using conventional methods in all centres, occasionally accompanied by MALDI-TOF/MS. Antifungal susceptibility testing was performed for amphotericin B, fluconazole, itraconazole, posaconazole, voriconazole and micafungin (as echinocandin class representative) using the CLSI microdilution method. Resistance rates were determined according to CLSI clinical breakpoints (CBPs). For drugs and species with undetermined CBPs, epidemiological cut-off values were used for wild-type (WT)/non-WT categorisation. Results: No or low rates of resistance were detected in general for tested Candida spp. isolates. Specifically, overall resistance to fluconazole in isolates of Candida parapsilosis SC and Candida glabrata SC were 7.7% and 0.9%, respectively. Resistance rates for C. parapsilosis SC varied extensively from one center to other (0-47.1%). Importantly, no echinocandin resistance was detected. Rates of non-WT isolates were also generally low: fluconazole against Candida lusitaniae, 4.3%; posaconazole against C. parapsilosis SC, 3.5%; posaconazole against Candida krusei, 1.9%; and voriconazole against C. glabrata SC, 0.5%. Conclusion: This is the first multicentre report of antifungal resistance rates among candidaemia isolates in Turkey, suggesting low resistance rates in general. Due to varying rates of fluconazole resistance in C. parapsilosis SC isolates that was detected at remarkably high levels in some centres, further studies are warranted to explore the source, clonal relatedness and resistance mechanisms of the isolates. (C) 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved., PfizerPfizer [WS776070], This study was supported by an Investigator-Initiated Research grant from Pfizer [WS776070 to SA-A]. The sponsor had no role in the study design, data collection or analysis, or manuscript preparation and submission.

Difficulties are being faced in the diagnosis of invasive fungal diseases due to the lack of sensitivity and specificity of the current diagnostic methods or taking too long time to get a result having clinical importance. Rapid diagnosis is the key point in patient outcomes. Excluding the culture tests, because of its rapid application and no need for invasive sampling, was making the serological tests based on the measurement of response of specific host antibody became attractive. However especially due to immunosuppressive conditions, these tests are not always the indicator of invasive disease in the patients who have no ability to produce specific antibody response. Detection of microbial antigens generally requiring a relatively large microbial burden, limits the assay sensitivity. Nonetheless, several examples of successful antigen detection systems have been developed, and some of these are widely used. To detect circulating Aspergillus galactomannans enyzme immunoassay (Platelia) method utilizing the rat monoclonal antibody EB-A2 is commercially in use. This test is able to detect galactomannan in the level of 0.5-1.0 ng/ml. Furthermore, galactomannan could be detected in the serum at a early stage of invasive aspergillosis before clinical signs and symptoms occured. However, this test has some disavantages like false positive or negative results. (1-3)-β-D-glucan is a characteristic cell-wall component of fungi except for Zygomycetes. A broad range of fungi including Aspergillus, During invasive infections (1-3)-β-D-glucan is released to the blood by some fungi containing Aspergillus, Candida, Fusarium, Trichosporon, Saccharomyces, OZET Invaziv mantar hastaliklarinin tanisinda, gunumuzde kullanilan yontemlerin duyarlilik ve ozgullugundeki yetersizlikler veya klinik olarak yararli olabilecek bir sonucun elde edilmesinin cok zaman almasi nedeniyle zorluklar yasanmaktadir. Hasta sonuclarinda, hizli tani anahtar noktadir. Kultur testleri disinda, konaktaki ozgul antikor yanitinin olculmesine dayali serolojik testlerin, hizli uygulanabilmesi ve invaziv ornek alim yontemleri gerektirmemesi bu testleri cekici kilmaktadir. Ancak ozellikle immunosupressif durumlar nedeniyle, ozgul antikor yaniti olusturamayan hastalarda bu testler her zaman invaziv hastalik gostergesi olmamaktadir. Mikrobiyal antijenlerin tespitinin ise genellikle daha fazla miktarda mikrobiyal yuk gerektirmesi duyarliligini kisitlamaktadir. Yine de cok sayida basariyla calisan antijen tespit sistemleri gelistirilmistir ve bunlarin bazilari halen yaygin olarak kullanilmaktadir. Dolasimdaki Aspergillus galaktomannanlarini tespit icin sican monoklonal EBA2’leri kullanan emzim immunoassay yontemi (Platelia) ticari olarak kullanimdadir. Bu test 0,5-1,0 ng/ml duzeyindeki galaktomannani tespit edebilmektedir. Ayrica, galaktomannan klinik belirti ve semptomlar olusmadan invaziv aspergillozun erken safhalarinda serumda tespit edilebilmektedir. Ancak, bu testin yanlis pozitif veya negatif sonuclar gibi dezavantajlari bulunmaktadir. (1-3)-β-D-glukan Zygomycetes’ler haric mantar hucre duvarinin karakteristik bir birlesenidir. Invaziv enfeksiyonlar sirasinda Aspergillus, Candida, Fusarium, Trichosporon, Saccharomyces, Acremonium ve Pneumocyctis jirovecii iceren bircok mantar tarafindan (1-3)-β-D-glukan kana salinmaktadir. 1 Ondokuz Mayis Universitesi, Tip Fakultesi, Tibbi Mikrobiyoloji ABD, SAMSUN Gelis Tarihi / Received : Kabul Tarihi / Accepted : Iletisim / Corresponding Author : Asuman BIRINCI Ondokuz Mayis Universitesi, Tip Fakultesi, Tibbi Mikrobiyoloji ABD, SAMSUN Tel : +90 362 312 19 19 3036 E-posta / E-mail : abirinci@omu.edu.tr 06.02.2015 23.10.2015 DOI ID : 10.5505/TurkHijyen.2016.74418 Turk Hijyen ve Deneysel Biyoloji Dergisi Birinci A, Tanriverdi-Cayci Y. Mantar enfeksiyonlarinin serolojik tanisi. Turk Hij Den Biyol Derg, 2016; 73(2): 175-82. Makale Dili “Turkce”/Article Language “Turkish”

WOS: 000341223900014 PubMed: 25052116 Aspergillus spp. are widespread in nature and cause severe infections especially in immunocompromised patients. Aspergillus fumigatus complex is the most common species that causes infections in humans; however Aspergillus niger complex and Aspergillus flavus complex are the emerging agents that are isolated frequently from clinical specimens more recently. Besides the host factors such as immunosuppression, hematologic malignancy and corticosteroid use, fungal virulence factors such as elastase, acid protease and phospholipase enzymes are considered among the factors that affect the development of invasive aspergillosis. The aim of this study was to detect the acid proteinase and phospholipase enzyme activities in 30 A.fumigatus complex, nine A.flavus complex and four A.niger complex strains isolated from clinical specimens. Acid proteinase and phospholipase activities of the isolates were investigated by using bovine serum albumin agar (BSA), and egg yolk agar plates, respectively. Acid proteinase and phospholipase activity was detected in 76.7% (23/30) and 93.3% (28/30) of A.fumigatus complex isolates, respectively. None of the nine A.flavus complex isolates exhibited acid proteinase or phospholipase activity. Acid proteinase activity was not detected in any of the A.niger complex isolates (n= 4), however phospholipase activity was detected in one (25%) isolate. All of the acid proteinase positive A.fumigatus complex strains (n= 23) were also positive for phospholipase activity. In conclusion, further larger scale multicenter studies supported by clinical data, are needed to enlighten the roles of acid proteinase and phospholipase in the pathogenesis of infections due to Aspergillus spp.

Akbal, Ahmet Ugur/0000-0002-0627-5326 WOS: 000380112500006 PubMed: 27304025 In this study we evaluated the crystal violet decolorization assay (CVDA) for detection of minimum inhibitory concentration (MIC) of antituberculosis drugs. 53 isolates were tested in this study and 13 of them were multidrug resistant (MDR) isolates. The antibiotics concentrations were 2-0.06 mg/L for isoniazid (INH) and rifampicin (RIF) and were 16-0.25 mg/L for streptomycin (STM) and ethambutol (EMB). Crystal violet (CV-25 mg/L) was added into the microwells on the seventh day of incubation and incubation was continued until decolorization. Decolorization of CV was the predictor of bacterial growth. Overall agreements for four drugs were detected as 98.1%, and the average time was detected as 9.5 +/- 0.89 day after inoculation. One isolate for INH and two isolates for STM were determined resistant in the reference method, but susceptible by the CVDA. One isolate was susceptible to EMB by the reference method, but resistant by the CVDA. All results were concordant for RIF. This study shows that CVDA is a rapid, reliable and suitable for determination of MIC values of Mycobacterium tuberculosis. And it can be used easily especially in countries with limited-sources.

WOS: 000360254000011 PubMed: 26313283 The incidence of fungal infections has increased in recent years. Antifungal resistance is a major problem with increasing frequency due to the widespread use of antifungal agents in infections. Identification of the Candida species and susceptibility patterns with the appropriate tests for resistance and selection of the empirical agents used for treatment are important. The aim of the study was to evaluate the changes of the epidemiology of Candida species and minimum inhibitory concentrations (MIC) of the antifungal agents, isolated in Mycology Laboratory of Ondokuz Mayis University Faculty of Medicine, between 1 January 2009 to 1 July 2012. The study was performed retrospectively based on records in the mycology unit and checked comparatively with the automation system in the hospital. The recurrent reproductions of the same patient were excluded. For the identification of Candida species APIelD 32C (bioMerieux, France) system was used. Information on the isolated material, patient's age, gender and the inpatients' clinics were recorded. The susceptibility of Candida species isolated from blood cultures were studied with Etest (bioMerieux, France) method. A total of 1238 isolates were included in the study. The most common species isolated from clinical samples was C.albicans with a rate of 51.1% (n= 632), followed by C.tropicalis with a rate of 15.8% (n= 195). Among the pediatric intensive care unit (ICU) patients C.parapsilosis 42% (n= 17) was the most common isolate and the second most common isolate was C.albicans 32% (n= 13). However, in the adult ICU the most common isolate was C.albicans 34% (n= 13) and the second was C.parapsilosis 31% (n= 12). When the distribution of Candida species were analyzed from the records of last four years, the frequency rate of C.albicans and non-albicans species was found as 51.1% (n= 632) and %48.9 (n= 606), respectively. Based on these data, a comparison was made between the years and no difference between the two groups in terms of the distribution of fungi within the specified time (x2: 3.2, df: 1, p: 0.073) was determined. Of the Candida species isolated from blood cultures, seven isolates (2.2%) were resistant to fluconazole in the study period. The differences of MIC levels in fluconazole were detected between the years 2010-2012 and 2011-2012. The geometric mean of the MICs in 2012 increased significantly compared to 2010 and 2011 (p< 0.01). There was no resistance to amphotericin B except for intrinsically resistant Candida lusitaniae. There were no significant differences among amphotericin MIC values between years (p> 0.05). According to the sensitivity results, fluconazole is still seen as an option that can be used for the first choice. Although it remains as the first antifungal choice, antifungal susceptibility testing of the identified fungi will help the clinician for the plan and continuation of the treatment.

WOS: 000224070400019 PubMed: 15325439 The nitrate reductase assay (NRA) was evaluated for susceptibility testing of Mycobacterium tuberculosis using 80 clinical isolates of M. tuberculosis and H37Rv as a control strain. All isolates were tested by the proportion method and the NRA for isoniazid (INH), rifampicin (RIF), streptomycin (STR) and ethambutol (ETM). The proportion method was carried out according to NCCLS on Lowenstein-Jensen (U) medium and the NRA on U medium containing 1000 mug/ml potassium nitrate (KNO3). After incubation for 7, 10, 14 and 21 days, Griess reagent was added to each LJ medium and nitrate reduction was determined by a colour change. Comparing the NRA with the proportion method, sensitivities were 100, 100, 82.1 and 92.2% for INH, RIF, STR and ETM, respectively. Specificities were 100, 100, 92.3 and 100% for INH, RIF, STR and ETM, respectively. The results of 2, 22 and 56 isolates were obtained after 7, 10 and 14 days, respectively. The proportion method result were read at 21-28 days. The NRA is rapid, inexpensive and easy to perform. Our results indicated that the NRA is suitable for the early determination of INH and RIF resistance in countries where sophisticated procedures are not always available. (C) 2004 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

WOS: 000220161500020 PubMed: 15057358 In this study, we have evaluated the broth microdilution method (BMM) for susceptibility testing of Mycobacterium tuberculosis. A total of 43 clinical isolates of M. tuberculosis and H37Rv as a control strain were studied. All isolates were tested by the proportion method and the BMM for isoniazid (INH), rifampicin (RIF), streptomycin (STR), and ethambutol (ETM). The proportion method was carried out according to the National Committee for Clinical Laboratory Standards (NCCLS) on Lowenstein-Jensen (LJ) medium. The BMM was carried out using 7119 broth with 96 well-plates. All strains were tested at 3.2-0.05 mug/ml, 16-0.25 mug/ml, 32-0.5 mug/ml, and 32-0.5 mug/ml concentrations for INH, RIF, STR, and ETM, respectively. When the BMM was compared with the proportion method, sensitivity was 100, 100, 96.9, and 90.2%, while specificity was 100, 85.7, 90.9, and 100% for INH, RIF STR, and ETM, respectively. The plates were examined 7, 10, 14, and 21 days after incubation. The majority of the result were obtained at 14th days after incubation, while the proportion method result were ended in 21-28 days. According to our results, it may be suggested that the BMM is suitable for early determining of multidrug-resistance-M. tuberculosis strains in developed or developing countries.

WOS: 000179772600008 PubMed: 12519356 The main objective of this in vitro study was to assess the effects of cefotaxime and ceftriaxone in killing Salmonella typhi in infected human macrophages. Human monocyte-derived macrophages isolated from peripheral blood of human volunteers were cultured in vitro for macrophage differentiation, and subsequently infected with S. typhi strains (a clinical isolate and a standard strain TA-42) at a cell ratio of 10 : 1. MICs of cefotaxime and ceftriaxone were determined by broth microdilution, and the antibiotics were included in the culture medium at one and five times their MIC values. Samples of cell culture medium taken at 0, 3, 6 and 24 h of incubation were cultured for growth of S. typhi on nutrient agar. Gentamicin (10 mg/L) was included in each well except for the control wells, in order to prevent growth of extracellular S. typhi . Both antibiotics showed good in vitro antibacterial effects against S. typhi strains. There were no statistically significant differences between the extracellular and intracellular effects of antibiotics with regard to elimination of the bacteria. Cefotaxime and ceftriaxone are highly effective against extracellular bacterial growth. The results of our in vitro experiments suggest that cefotaxime and ceftriaxone might also be used clinically against susceptible intracellular pathogens such as S. typhi.

WOS: 000339285000001 PubMed: 25023905 Aim: Super-oxidized water is one of the broad spectrum disinfectants, which was introduced recently. There are many researches to find reliable chemicals which are effective, inexpensive, easy to obtain and use, and effective for disinfection of microorganisms leading hospital infections. Antimicrobial activity of super-oxidized water is promising. The aim of this study was to investigate the in-vitro antimicrobial activity of different concentrations of Medilox r super-oxidized water that is approved by the Food and Drug Administration (FDA) as high level disinfectant. Material and methods: In this study, super-oxidized water obtained from Medilox r [Soosan E & C, Korea] device, which had been already installed in our hospital, was used. Antimicrobial activities of different concentrations of super-oxidized water (1/1, 1/2, 1/5, 1/10, 1/20, 1/50, 1/100) at different exposure times (1, 2, 5, 10, 30 min) against six ATCC strains, eight antibiotic resistant bacteria, yeasts and molds were evaluated using qualitative suspension test. Dey-Engley Neutralizing Broth [Sigma-Aldrich, USA] was used as neutralizing agent. Results: Medilox r was found to be effective against all standard strains (Acinetobacter baumannii 19606, Escherichia coli 25922, Enterococcus faecalis 29212, Klebsiella pneumoniae 254988, Pseudomonas aeruginosa 27853, Staphylococcus aureus 29213), all clinical isolates (Acinetobacter baumannii, Escherichia coli, vancomycin-resistant Enterococcus faecium, Klebsiella pneumoniae, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, Bacillus subtilis, Myroides spp.), and all yeastsat 1/1 dilution in = 1 minute. It was found to be effective on Aspergillus flavus at 1/1 dilution in = 2 minutes and on certain molds in = 5 minutes. Conclusion: Medilox r super-oxidized water is a broad spectrum, on-site producible disinfectant, which is effective on bacteria and fungi and can be used for the control of nosocomial infection.

In this study, blood agar was used instead of 7H10 agar for the susceptibility testing of 34 clinical isolates of Mycobacterium tuberculosis to isoniazid (INH) and rifampin (RIF) in accordance with the NCCLS. The BACTEC 460 TB system (Becton Dickinson, Sparks, Md.) was used as a “gold standard.” Results for both media were in agreement for RIF and INH at 100 and 94.1%, respectively. For INH, the specificity, sensitivity, positive predictive value, and negative predictive value were found to be 71.4, 100, 93.1, and 100%, respectively, while these values were 100% for RIF. In addition, the results of the susceptibility test performed with blood agar were obtained on day 14 of incubation. In conclusion, results were obtained much earlier with blood agar (2 weeks) than with 7H10 agar (3 weeks), and the results of this study suggest that blood agar may be used as an alternative medium for the susceptibility testing of M. tuberculosis to INH and RIF. The increasing incidence of multidrug-resistant tuberculosis (MDR-TB) produces serious problems in developed and especially in developing countries. Detecting tuberculosis and identifying MDR Mycobacterium tuberculosis strains by conventional methods is difficult because of the low growth rate of the causative agent. Therefore, rapid and efficient methods are needed for the control of this disease (3–6, 13). Several manufacturers have directed considerable effort toward the development of rapid and efficient systems for the growth, detection, and susceptibility testing of mycobacteria. Two of these systems, the BACTEC 460 TB (Becton Dickinson, Sparks, Md.) and the BACTEC MGIT 960 (Becton Dickinson), have become available for the susceptibility testing of M. tuberculosis and are also recommended by the NCCLS. Although the time to detect M. tuberculosis from clinical specimens can be shortened and the results for susceptibility testing can be obtained in 4 to 7 days by the use of these systems, they are labor-intensive and expensive and generate radioactive waste (2–4, 12). Therefore, several methods based on liquid media have been developed by different investigators for the susceptibility testing of M. tuberculosis (2, 4–6, 10, 11, 13, 14). Drancourt et al. (7) investigated the effectiveness of blood agar for primary isolation of M. tuberculosis. They reported that M. tuberculosis can easily grow on blood agar in 1 to 2 weeks and that this medium has been routinely used instead of egg-based medium in the inoculation of 10,000 samples in a year for the diagnosis of tuberculosis, with the same results being obtained. In this study, we evaluated the performance of blood agar for susceptibility testing of 34 M. tuberculosis clinical isolates to

11th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) -- APR 01-04, 2001 -- ISTANBUL, TURKEY WOS: 000175405500013 PubMed: 12048564 The aim of this study was to investigate the correlation between proportion method with mycobacteria growth indicator tube (MGIT) and E-test for Mycobacterium. tuberculosis. Foro, clinical isolates were tested. MGIT and E-test with the first line antituberculous drugs correlated with the proportion method. Our results suggested that MGIT and E-test methods can be routinely used instead of the proportion method. European Soc Clin Microbiol & Infectious Dis, European Study Grp Antimicrobial Policies

WOS: 000414023000004 PubMed: 29091135 BACKGROUND Mycobacterium tuberculosis (MTB) is one of the most significant causes of mortality and morbidity. Early diagnose is important especially in multiple drug resistant tuberculosis to avoid transmission. Traditional techniques requires at least one to three weeks for diagnosis of tuberculosis. Diagnostic delays with multiple drug resistant tuberculosis are associated with worse clinical outcomes and increased transmission The Xpert MTB/RIF assay is one of the new diagnostic device for the diagnosis of tuberculosis and rapid detection of rifampicin resistance. OBJECTIVE We assessed the performance of Xpert MTB/RIF assay for detecting rifampicin resistance using phenotypic drug susceptibility tests as automated BD MGIT 960. METHODS Total of 2136 specimens were included in the study. Xpert MTB/RIF testing was performed on samples, using version 4 cartridges, according to the manufacturer's recommendations. The MTBC culture and first-line phenotypic DST were performed in automated BD MGIT 960 (Becton & Dickinson, USA) according to the recommendations of the manufacturer. Agar proportion was used in the case of inconsistency for rifampicin resistance. FINDINGS Thirty-four samples (19 respiratory and 15 nonrespiratory samples) were determined as positive for M. tuberculosis complex by Xpert MTB/RIF (Cepheid GeneXpert (R) System, USA). Xpert MTB/RIF assay detected 4/34 (11.7%) specimens as rifampicin resistant. One of the rifampicin resistant isolates was determined susceptible in MGIT 960 automated system. This isolate was also tested with agar proportion method and found susceptible to rifampicin. MAIN CONCLUSION The Xpert MTB/RIF assay can be used as first-line assay for the detection of M. tuberculosis. However, microbiologists must be aware of the limitations of the assay.