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In order to determine the possible etiologic agents and their antibiotic sensitivities frorn patients with hernatologic malignancies, throat, nose, urine, fecal and blood specimens from 98 rnale and 38 female patients were evaluated microbiologically. Out of a total of 612 culture specirnens, the probable pathogens which were isolated, included 188 (30.72%) Gram positives and 66(10.78 %) Gram negatives. Bacteria which might have been possible cause of infection were not isolated from 358 specimens. The Gram positive bacterium most frequently isolated was S.aureus(39.8 %) the most effective antibiotic was amikacin (71 %) and the least effective was penicillin (34 %). Out of the Gram negative bacteria, E.coli was most frequently isolated and the most effective antibiotics were aztreonam (72 %), amikacin (71 %) and ofloxacin (71 %). The least effective were chloramphenicol (17 %) and amoxycillin (32 %).

The presence of Herpes Simplex Virus-type 2 (HSV type 2), Cytomegalovirus(CMV) and Adenovirus lgG antibodies was determined in sera from a total of 144 patients with hematologic and solid organ malignancies. HSV type-2 antibodies were detected using the EIA method and antibody levels were detected in 34(48.5 %) ofthe hematologic and in 56(75.6 %) ofthe solid organ malignancies with a total of90 (62.5 %). Anti-CMV IgG antibodies were detected in the same serum samples using the complement fixation test. Residual anti-CMV antibody levels were detected in 43(61.4) ofhematologic and 39 (52.7 %) ofsolid organ malignancies with a total of82 (56.9 %) serum samples. Adenovinıs antibodies were detected using the complement fixation test. Residual antibodies were found in 51(72.8 %) of hematologic and in 33(44.5 %) of solid organ malignancies cut of a total of 84(58.3 %).

PubMedID: 31651120 Background/aim: Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation. The study aimed to assess serum 14-3-3eta, anti-CarP, and anti-Sa in seronegative RA (SNRA) patients who were treatment-naïve as well as in healthy subjects. This is the first study in the literature to examine these autoantibodies together in SNRA patients. Materials and methods: Forty-five treatment-naïve SNRA patients and 45 healthy subjects were recruited. Drugs change the levels of autoantibodies; therefore, patients who took any medication had been excluded from our study. Anti-carbamylated protein, anti-Sa, and 14-3-3eta were measured by using three different ELISA kits. Results: Median serum concentration of healthy controls in 14-3-3eta was 0.02 (0.02–0.27) ng/mL. Median serum concentration of SNRA patients in 14-3-3eta was 1.00 (0.48–1.28) ng/mL. Data were analyzed with Mann–Whitney U tests; the P-value was

Objectives: To determine the serotype distribution of pneumococcus causing invasive pneumococcal disease (meningitidis, bacteremia and empyema) in children in Turkey, and to observe potential changes in this distribution in time to guide effective vaccine strategies. Methods: We surveyed S. pneumoniae with conventional bacteriological techniques and with real-time polymerase chain reaction (RT-PCR) in samples of cerebrospinal fluid (CSF), blood and pleural fluid. S. pneumoniae strains were isolated from 33 different hospitals in Turkey, which are giving health services to approximately 60% of the Turkish population. Results: A total of 167 cases were diagnosed with invasive pneumococcal disease between 2015 and 2018. We diagnosed 52 (31.1%) patients with meningitis, 104 (62.2%) patients with bacteremia, and 11 (6.6%) patients with empyema. Thirty-three percent of them were less than 2 years old and 56% less than 5 years old. Overall PCV13 serotypes accounted for 56.2% (94/167). The most common serotypes were 19 F (11.9%), 1 (10.7%) and 3 (10.1%). Conclusions: Besides the increasing frequency of non-vaccine serotypes, vaccine serotypes continue to be a problem for Turkey despite routine and high-rate vaccination with PCV13 and significant reduction reported for the incidence of IPD in young children. Since new candidate pneumococcal conjugate vaccines with more serotype antigens are being developed, continuing IPD surveillance is a significant source of information for decision-making processes on pneumococcal vaccination. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC., Pfizer, The study was supported by Pfizer.

WOS: 000484452900003 PubMed ID: 30872923 Aim: To evaluate the effect of umblical cord clamping time on lymphocyte subgroups in term and late preterm infants. Material and Methods: Seventy-four infants between 34 and 41 weeks of gestation were included in the study. Of these, 37 were umbilical cord clamped immediately after birth and the remaining 37 were clamped after waiting one minute. Babies were divided into two groups as term and preterm. The prenatal, natal, postnatal characteristics of the infants were recorded. Hematologic and lymphocyte subgroups were investigated in cord blood and venous blood at day 7. Lymphocyte subgroups were evaluated using flow cytometry. Results: With the delay of cord clamping, the leucocytes count and the percentage of CD3+T lymphocytes in cord blood of preterm infants decreased and this decrease continued at day 7. On the contrary, CD19+B lymphocyte levels in the cord blood of preterm infants increased, and this increase continued at day 7. Also, the percentage of CD4+T lymphocytes of preterm infants decreased with the delay of cord clamping at day 7. There was no difference between groups for the rate of sepsis development. Conclusion: With the delay of cord clamping, the leucocytes count, the percentage of CD3+T, and CD4+T lymphocytes decreased, and the percentage of CD19+B lymphocytes increased in preterm infants. The delay in cord clamping time in term and preterm infants seems to have no impact on the rate of sepsis development. Larger series of studies are needed to assess the effect of these findings on the development of infection in late preterm infants who have delayed cord clamping. Cukurova University Scientific Research Project Development Fund The authors received financial support from Cukurova University Scientific Research Project Development Fund.

PubMedID: 27414726 Background/objectives Systemic sclerosis (SSc) is a progressive autoimmune disorder with multi-organ involvement. Patients who have SSc are at risk of developing pulmonary arterial hypertension (PAH) and right heart failure. Impaired right heart hemodynamic function is the most powerful predictor of mortality in these patients. We assessed the interactions between levels of NT-proBNP, cystatin C, and right ventricular functions in SSc patients without significant PAH. Methods Fifty SSc patients without significant PAH (37 women and 13 men, mean age 47.2 ± 10.3), and 44 healthy participants as a control group (29 women and 15 men, mean age 47.9 ± 10.4) were included in the study. Results Cystatin C and NT-proBNP levels were significantly higher in patients with SSc. Both cystatin C and NT-proBNP levels possitively correlate with age, interventricular septum thickness, left ventricular posterior wall thickness, systolic pulmonary artery pressure, the peak late diastolic filling velocity, tricuspid regurgitation velocity, and negatively correlate with pulmonary artery acceleration time in the patients. Conclusions Our results showed that elevated cystatin-C and NT-proBNP levels may be a clue for diastolic impairment in right ventricular functions in SSc. © 2016 Elsevier Ireland Ltd Our study was funded by the scientific research project support unit of Cukurova University.

PubMedID: 27121140 Background: Neuron-specific enolase (NSE) is a recognized biomarker for the assessment of cerebral injury in neurological disorders. This study aims to report a definitive assessment of the biological variation (BV) components of this biomarker, including within-subject BV (CVI), between-subject BV (CVG), index of individuality (II), and reference change value (RCV), in a cohort of Turkish participants using an experimental protocol. Methods: Six blood specimens were collected from each of the 13 apparently healthy volunteers (seven women, six men; ranging in age from 23 to 36) on the same day, every 2 weeks for 2 months. Serum specimens were stored at -20°C until analysis. Neuron-specific enolase levels were evaluated in serum samples using an electrochemiluminescence (ECLIA) immunoassay kit with a Roche Cobas e 411 auto-analyser. ANOVA test was used to calculate the variations. Results: The CVI and CVG for NSE were 21.5% and 28.8%, respectively. Analytical variation (CVA) was calculated as 10.2%. Additionally, II and RCV were calculated as 0.74 and 66% (95% confident interval, CI), respectively. Conclusion: As the performance index (PI) was found to be less than 2 (PI = 0.95), it is concluded that the NSE measurements have a desirable performance for analytical imprecision. Since the II was found to be less than 1 (II: 0.74), the reference values will be of little use. Thus, RCV would provide better information for deciding whether a significant change has occurred. © 2016 Wiley Periodicals, Inc.

WOS: 000466333800022 Brucellosis is the most common zoonotic disease in the Mediterranean region where Turkey is located. Therefore, particularly in this region, it is crucial to follow molecular surveillance methods for the control and eradication of this disease agent, which threatens both human and animal life. We have conducted a molecular-based surveillance study for detecting the origin of the possible reservoir in human brucellosis and transmission of Brucella spp. between humans and ruminants. For the detection of clonal relationships, we isolated Brucella spp. from human and ruminants diagnosed with brucellosis and evaluated them by PFGE and MLVA methods. We found 10 subclusters in PFGE and 22 subclusters in MLVA-16. Human and ruminant isolates were found to co-exist in MLVA-16-m1 and PFGE-a8, a9, a10 subcluster by both methods. In conclusion, the results revealed that these subcluster isolates that co-exist some ruminant and human isolates can be more effective in infecting humans. Cukurova University Scientific Research FundCukurova University [TF2013D2] This research was financially supported by Cukurova University Scientific Research Fund (Project no: TF2013D2).

Purpose: The aim of this study is to examine the relationship between Pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections (PANDAS) and Human Leukocyte Antigen (HLA) alleles. Materials and Methods: HLA alleles of 41 children patients, whom are diagnosed with rapid onset of obsessive compulsive disorder (OCD), and 88 healthy children are analyzed by using PCR. Results are evaluated by using univariate and multivariate logistic regression analysis.Results: DRB8, DRB5.2 and DQ5 alleles increase risk of disease while A1, B18 and B35 alleles decrease risk of disease. Conclusion: Findings of this study will help researchers to examine related genes in PANDAS and the effects of gene products on development of the disease. Presentation of exogenic antigens to T-helper cells by HLA class II loci is determined in different autoimmune diseases. Similarity of these findings with PANDAS etiology and risk increasing alleles found in this study being HLA class II is remarkable., Amaç: Bu çalışmada Streptokok enfeksiyonları ile ilişkili pediyatrik otoimmün nöropsikiyatrik bozukluklar (PANDAS) ve İnsan Lökosit Antijen (HLA) allelleri arasındaki ilişkinin incelenmesi amaçlanmıştır.Gereç ve Yöntem: Ani başlangıçlı obsesif kompulsif bozukluğu (OKB) olan 41 çocuk hastanın ve 88 sağlıklı çocuğun HLA alelleri PCR kullanılarak analiz edildi. Sonuçlar univariate ve multivariate lojistik regresyon analizi kullanılarak değerlendirildi.Bulgular: A1, B18 ve B35 allellerinin hastalık riskini azaltırken, DRB8, DRB5.2 ve DQ5 allellerinin hastalık riskini artırdığı saptanmıştır.Sonuç: Bu çalışmanın bulguları, araştırmacıların PANDAS'taki ilgili genleri ve gen ürünlerinin hastalığın gelişimine olan etkilerini incelemelerine yardımcı olacaktır. HLA sınıf II lokusları tarafından T-yardımcı hücrelere ekzojenik antijenlerin tanıtımı farklı otoimmün hastalıklarda belirlenmiştir. Bu bulguların PANDAS etiyolojisi ile benzerliği ve bu çalışmada bulunan hastalık riskini artıran allellerin, HLA sınıf II’de bulunması dikkat çekicidir.

WOS: 000373443300012 PubMed ID: 26927460 Introduction: This study was aimed to determine the relationship between vitamin D and soluble vitamin D receptor (VDR) levels and brucellosis, a common infection in Turkey, in which the cellular immune system is important in the course of the disease. Methodology: Patients who had been followed up in the Department of Infectious Diseases and Clinical Microbiology of Cukurova University Medical Faculty, having been diagnosed with brucellosis and who had no brucellosis treatment before, were enrolled in the study along with healthy controls. The participants' vitamin D and soluble VDR values were recorded. Laboratory parameters of patients and controls, clinical findings, and disease course of brucellosis patients were also noted. Results: The mean age of the 86 brucellosis patients, of whom 38 (44.2%) were males and 48 (55.8%) were females, was 40.9 +/- 18.4 years. Complicated course of brucellosis rate was found to be 29.1%. Vitamin D and VDR levels were lower in brucellosis patients at the time of diagnosis compared to control group. For males, vitamin D and VDR levels were higher in the control group than in the patient group. In males, VDR levels were higher than in females. A significant difference was not found between clinical forms of the disease and vitamin D and VDR levels. Conclusions: Vitamin D and VDR levels were shown to be significantly lower in brucellosis patients before treatment compared to the control group. These results suggest that vitamin D could be involved in the pathogenesis of the disease.

PubMedID: 30355342 Background: Rapid detection of sources and transmission routes by molecular methods provides key data for risk management of methicillin-resistant Staphylococcus aureus-induced infections acquired in both the community and hospitals. This study aimed to determine the clonal relationship of methicillin-resistant S. aureus strains isolated from our hospital by pulsed-field gel electrophoresis (PFGE) and Staphylococcal protein A (spa) typing methods and to identify the predominant clones in Cukurova Region, Turkey. Results: All isolates analyzed by PFGE were distributed among 11 clusters. Clusters A (n = 19) and B (n = 27) were 84.1% similar and accounted for 61% of all samples. All isolates were distributed among 18 spa types, with the most common type being t030 with 31 isolates (41.3%), followed by t223 with nine isolates (12%) and t127 with seven isolates (9.3%). Conclusions: We found that t030 was the most common spa type in the area where the study was conducted, as also previously shown in studies undertaken in Turkey. However, the rate of t030 in our study was below the rates reported in the literature. We also detected some rare or sporadic spa types like t127, which has not been previously defined in our country. We consider that the spa typing and PFGE methods are useful for research on clonal relations in monitoring the changing prevalent clones in specific regions. © 2018 The Author(s). Firat University Scientific Research Projects Management Unit: TF2012LTP40/TSA-2016-5577 This study was financially supported by Cukurova University Scientific Research Projects (TF2012LTP40/TSA-2016-5577), Adana, Turkey.

PubMedID: 25910370 BACKGROUND/AIMS: The aim of the study was to determine the epidemiological shift that may have occurred in the last 11 years of Hepatitis A virus (HAV) seroprevalence.MATERIALS AND METHODS: In 1998, we reported the anti-HAV seroprevalence in 711 children aged between 2 and 16 years children in Adana city center. Eleven years later we repeated the same study at the same locations in a similar population with the same method.RESULTS: From 1998 to 2009 anti-HAV seroprevalence declined from 33.9% to 22.2%, 29.5% to 25.3% (p>0,05), 52.2% to 30.8%, 69.7% to 35.2%, 66.9% to 37.7% and 71.4% to 47.3% (p

PubMedID: 24407110 Background: Killer cell immunoglobulin-like receptors (KIRs) are a family of inhibitory and activating receptors expressed by natural killer (NK) cells and regulate NK cell activity in the innate response against viral infections. The aim of this study was to determine the possibility of KIR genes and genotypes as a candidate for susceptibility to or protection against chronic hepatitis B virus (HBV) infection or spontaneous remission of the infection in a Turkish cohort. Material/Methods: The present study was carried out on 37 patients with chronic HBV infection, 36 patients in spontaneous remission of HBV infection, and 85 healthy subjects. Sequence-specific oligonucleotide probes analysis was used to investigate 16 KIR genes. All data were statistically analyzed by the Fisher exact test. Results: The rate of inhibitory KIR2DL3 (p=0.0) and 3DS1 (p=0.0) were higher in the healthy group than the group composed of chronic HBV patients and patients with spontaneous remission. There were no statistically significant differences between the rate of AA and Bx genotypes of chronic HBV patients and patients with spontaneous remission and the control group (p>0.05). Conclusions: Our results suggest that KIR2DL3 and KIR3DS1 genes could be protector genes for HBV infection and they could be important immuno-genetic markers in determining antiviral immunity in the Turkish population. © Med Sci Monit, 2014.

Background Biological variation (BV) data of analytes have been used to evaluate the significant changes in serial results (reference change value, RCV) of healthy individuals in clinical laboratories. However, BV data of healthy subjects may not be identical to the analytes of patients with ongoing clinical condition. The aim of this study was to calculate intra-(CVw) (coefficient of variation for intra-individual BV) and inter-individual (CVg) BV, index of individuality, and RCV of nine serum analytes of renal posttransplant patients. Methods Six serum specimens were obtained in an interval of two months in a one-year period from 70 transplant patients who had been stable for three years. Each time creatinine, uric acid, urea, sodium, potassium, calcium, inorganic phosphate, total protein, and albumin of these patients were analyzed with an integrated clinical chemistry/immunoassay auto-analyzer. ANOVA tests were used to calculate the variations. Results were compared with the data of healthy subjects obtained from BV database. Results CVw of all nine analytes of the renal transplant patients were higher than the healthy subjects. RCVs of these analytes were calculated as 14.5% for creatinine, 16.5% for urea, 13.7% for urate, 12.57% for albumin, 8.26% for total protein, 3.25% for sodium, 12.81% for potassium, 5.88% for calcium, and 21.57% for inorganic phosphate. Conclusion RCV concept for predicting the clinical status in posttransplant population represents an optimization of laboratory reporting and could be a valuable tool for clinical decision.

Objective: Cystic fibrosis is the most common autosomal recessive inherited disorder seen in the white populations. It develops in result of mutations of cystic fibrosis transmembrane regulator (CFTR) gene. Rate of these mutations vary in different geographical regions. In this study, we aimed to determine the frequency of CFTR gene mutations in Adana. Methods: DNA samples of 63 subjects (21 women, 42 men) who were diagnosed as cystic fibrosis at Balcalı Hospital of Çukurova University, were studied for 19 different CFTR mutations by the strip assay method which is based on reverse hybridization. Results: In cystic fibrosis diagnosed patients, 19 mutations were observed of which 9 were homozygous and 10 were heterozygous. ∆F508 frequency was found as 11.9%, and rate of homozygous was found as 66.7%. Mutation frequencies of W1282X and N1303K were found as 2.40% and 4.80% respectively and rate of homozygous mutations were 50% for both. I148T mutation frequency was found as 3.20% and all were heterozygous. For the whole 19 mutations, frequency of mutation in 63 subjects was 22.3%. Conclusion: Detection of CFTR gene mutations by the strip assay method by reverse hybridization is an easy, fast and informative method. However, due to improvability of the common mutations in probable cystic fibrosis patients because of heterogenity in this region, it is still a major problem and does not exclude cystic fibrosis diagnosis. But this problematic issue can be overcome by evaluating the whole exons of CFTR mutations by advanced molecular tecniques. Key words: CFTR, cystic fibrosis, molecular diagnosis, reverse hibridisationKey words, ÖZET Amaç: Kistik fibrozis (KF) beyaz ırkta en sık gözlenen otozomal resesif özellik gösteren kalıtımsal bir hastalıktır. Bu hastalık kistik fibrozis transmembran regulator (CFTR) genindeki mutasyonlara bağlı olarak gelişir. Mutasyonlardaki dağılım oranları değişik ülke ve bölgelere göre farklılık göstermektedir. Bu çalışmada Adana İlinde CFTR geni mutasyonlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışmada KF tanısı alan (21 kadın, 42 erkek) toplam 63 hastanın DNA örnekleri 19 farklı CFTR mutasyonu açısından ters hibridizasyona dayalı "strip assay" yöntemi ile incelenmiştir. Bulgular: KF tanılı hastaların 19"unda (9"unda homozigot, 10"unda heterozigot mutasyon) saptanmıştır. ∆F508 sıklığı %11.90, homozigotluk oranı ise %66.7 olarak bulunmuştur. W1282X mutasyon sıklığı %2.40 ve N1303K mutasyon sıklığı %4.80 bulunmuş olup homozigotluk oranları %50" dir. I148T mutasyonu %3.20 olarak saptanmıştır ve hepsi heterozigottur. Taradağımız 19 mutasyon için hastaların toplam mutasyon oranı ise % 22.3 olarak bulunmuştur. Sonuç: CFTR geni mutasyonlarının rutin laboratuarlarda saptanabilmesi için ters hibridizasyona dayalı "strip assay" tekniği hızlı, kolay ve bilgi verici bir yöntemdir. Bununla birlikte sonuçlarımızdaki heterojenite, şüpheli bir KF vakasında, yaygın bulunan mutasyonların kanıtlanamaması durumu, halen potansiyel bir sorun olarak kalmaya devam etmektedir ve bu durum tanıyı dışlamamaktadır. Bu sorun CFTR mutasyonunun bulunduğu ekzonların tamamının daha ileri moleküler teknikler ile incelenmesiyle ortadan kaldırılabilir.

PubMedID: 28342642 The study has evaluated the performance of HCV core antigen (Cag) test by comparing HCV RNA PCR assay which is considered the gold standard for management of HCV infection. Totally, 132 samples sent for HCV RNA (real-time PCR) test were included in the study. Anti-HCV antibody test and HCV Cag test were performed by chemiluminescent enzyme immunoassay (CMEI). Anti-HCV test was positive in all samples. HCV RNA was detected in 112/132 (84.8%) samples, and HCV Cag in 105/132 (79.5%). The most common HCV genotype was genotype 1 (86%). Considering the HCV RNA test as gold standard; the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Cag test were found to be 93.75%, 100%, 100%, 74.07% and 94.69%, respectively, and paired test results were detected as highly concordant. A high level of correlation was seen between HCV RNA and Cag tests, however, the concordance between the two tests appeared to be disrupted at viral loads lower than 103 IU/mL. On the contrary, the correlation reached significance for the values higher than 103 IU/mL. Viral loads were in the 17–2500 IU/mL range for the negative results for Cag test. Pearson's correlation coefficient revealed a considerably high correlation. The concordance between HCV RNA and Cag tests was disrupted under a viral load lower than 103 IU/mL. Therefore, it would be appropriate to consider cost effectiveness, advantages and limitations of the HCV RNA and Cag tests during the decision on which method to use for patient management. © 2017 Elsevier Ltd

Amaç: HCV'nin neden olduğu kronik karaciğer hastalığının tedavi ve takibinde genotiplerin belirlenmesi kritik öneme sahiptir. Bu çalışmada, HCV genotiplemesi için Çukurova Üniversitesi Tıp Fakültesi Hastanesi Merkez Laboratuvarına gönderilen kan örneklerinde elde edilen sonuçlar ve hasta dosya bilgileri kayıtlardan incelenerek bölgemizdeki HCV genotiplerinin dağılımı ve bulaş yolları belirlenmiştir. Yöntem: Ocak 2015-Ağustos 2016 tarihleri arasında Çukurova Üniversitesi Tıp Fakültesi Hastanesi Merkez Laboratuvarında, HCV-RNA (COBAS AmpliPrep/COBAS Taq Man HCV real-time PCR, Roche Diagnostics, Germany) pozitif saptanan hastalardan HCV genotip tayini yapılan 119 hastaya ait sonuçlar kayıtlardan incelendi. Hastaların demografik verileri, hastane elektronik bilgi sisteminden ve hasta dosyalarından elde edildi. Genotipleme için genotip 1a, 1b, 2, 3, 4, 5a ve 6'yı gerçek zamanlı PCR yöntemi ile saptayan "Sacace HCV Genotype Plus Real TM" kiti kullanıldı. Bulgular: 119 hastadan oluşan çalışma grubunda %71,4 genotip 1 (%12,6 genotip 1a, %58,8 genotip 1b), %16,8 genotip 3, %7,6 genotip 2, %3,4 genotip 4 enfeksiyonu saptandı. Suriyeli kadın hastada,Adana'da daha önce bildirilmemiş olan genotip 5a (%0,8) enfeksiyonuna rastlandı. Genotip 3 enfeksiyonu saptanan hastaların %45,0'inde ve genotip 2 enfeksiyonu saptanan hastaların %33,3'ünde damar içi uyuşturucu (DIU) kullanımı söz konusu olup çoğunluğunu genç erkek (%83,3) hastalar oluşturmakta idi. Ayrıca psikiyatrik hastalığı ve intihar girişimi öyküsü olan ve DIU kullanımı açısından riskli dört hastada da genotip 3 enfeksiyonu tespit edildi. Tamamına yakını tıbbi uygulamalarla ilişkili olan Suriyeli 11 hastadaki HCV genotiplerinin dağılımı sırasıyla %63,6 genotip 1a, %27,3 genotip 4 ve %9,1 genotip 5a olarak belirlendi. Sonuç: Türkiye'de HCV enfeksiyonunun epidemiyolojisi son yıllarda değişiklik göstermektedir. Her ne kadar ülkemizde tıbbi uygulamalar temel risk faktörü ve genotip 1b enfeksiyonu prevalansı %85-90'larda olsa da son yıllarda genotip 1b enfeksiyonunun prevalansı azalmaktadır. Diğer genotiplerin görülme sıklığı artmakta ve Suriyeli göçmenlerde daha önce ülkemizde saptanmayan genotip 5 enfeksiyonlarına rastlanmaktadır. Adana gibi Türkiye'nin güneyindeki illerde DIU kullanımı ile ilişkili genotip 2 ve özellikle genotip 3 enfeksiyonlarında artış görülmektedir. Tıbbi uygulamalarda güvenliğin artırılması HCV enfeksiyonu riskini azaltsa da, DIU kullanımının artması, gelecekte de HCV enfeksiyonunun önemini koruyacağını göstermektedir Objective: Determination of the genotype is critical in process of treatment and detection of cronic liver diease caused HIV infection. In this study, we examined blood samples of patients which have been sent to the Central Laboratory of Çukurova University Medical Faculty Hospital for HCV genotyping and the distrubition and transmission routes of HCV genotypes in our region have been determined by examining patients file records. Methods: Between January 2015 and August 2016, HCV genotypes of 119 HCV-RNA (COBAS AmpliPrep / COBAS TaqMan HCV real-time PCR, Roche Diagnostics, Germany) the results of 119 patients who were identified as positive for HCV genotype were examined respectively from the record in Central Laboratory of Çukurova University Medical Faculty Hospital. The demographic data of patients were obtained from the hospital electronic information system and patient files. “Sacace HCV Genotype Plus Real TM” kit was used for HCV genotyping which can detect genotype 1a, 1b, 2, 3, 4, 5a, 6 by real-time PCR method. Results: In the study of 119 patients, genotype 1 was detected in 71,4% (12.6% genotype 1a, 58.8% genotype 1b), genotype 3 in 16.8%, genotype 2 in 7.6%, genotype 4 in 3.4%. Genotype 5 (5a) (0.8%) which has not been reported previously in Adana, was determined in a Syrian female patient. 45.0% of patients who were infected with genotype 3 and 33.3% of patients with genotype 2 infection were intravenous drug users (IVDUs); and young men (83.3%) constituted the majority of this patient group. In addition, genotype 3 infection was detected in 4 patients who were have a risk for being IVDU with psychiatric disorders and suicide attempt. The distrubition of HCV genotypes in 11 Syrian patients nearly completed medical interventions was 63.6% genotype 1a, 27.3% genotype 4 and 9.1% genotype 5a respectively. Conclusion: Epidemiology of HCV infection has varried in Turkey in recent years. Although medical interventions are the main risk factor and genotype 1b infection prevalence is 85-90% in our country, genotype 1b infection prevalence has been decreasing in recent years. The incidence of other genotypes are increasing, and previously undetected genotype 5 infection has been determined in Syrian immigrants in our country. Genotype 2 and genotype 3 infections which are associated with intravenous drug use have been increased in southern Turkey, such as Adana. Although transmission risk of HCV infection with medical interventions has decreased with increasing infection control measurement practice, the increasing number of IVDUs will be important in the HCV infection transmission in the future.

PubMedID: 28743652 Objectives In recent years, carbapenem-resistant Klebsiella pneumoniae (CRKP) have become an important threat to hospitalised patients. This study aimed to identify the genetic mechanisms of carbapenem resistance in CRKP isolated from patients in a Turkish centre. Methods During 2013–2014, a total of 98 K. pneumoniae isolated from patients at Çukurova University Balcalı Hospital (Adana, Turkey) determined phenotypically as resistant to carbapenems were screened genotypically for the presence of carbapenemase enzymes by multiplex PCR. Results Of the 98 patients for whom genetic investigation was made, 93 (94.9%) were adults, 56 (57.1%) were male and 81 (82.7%) were diagnosed as infected. The mean and median age were 51.8 ± 20.5 years and 55 years (range 1–89 years), respectively. The nosocomial infection rate was 87.8% (86/98). The mortality rate was 41.8% (41/98). Fifty-eight patients (59.2%) were admitted to intensive care units. Of the 12 non-nosocomial infections, 5 (41.7%) originated from the inpatient clinic of the urology department. The mean and median hospital length of stay (LOS) were 20.7 ± 20.8 days and 17 days (range 0–90 days), respectively. The most common carbapenemase gene detected was blaOXA-48 (74.5%), followed by blaVIM (45.9%) and blaSME (37.8%). The blaNDM gene was detected in 20 isolates (20.4%). The most effective antibiotics were tigecycline and colistin, with susceptibility rates of 87.5% and 74.3%, respectively. Conclusions Multiple resistance mechanisms were present in CRKP isolates in Turkey. Most of the isolates harboured blaOXA-48, blaVIM and blaSME genes; meanwhile, the rate of 20.4% for blaNDM is alarming. © 2017 International Society for Chemotherapy of Infection and Cancer

Kibar, Filiz/0000-0003-2983-2399; Aktas, Zerrin/0000-0002-5998-0440; Ogunc, Dilara/0000-0001-6669-6811; gelmez, gulsen altinkanat/0000-0003-0274-628X; WOS: 000269414100003 PubMed: 19622455 Resistance rates to amikacin, ciprofloxacin, ceftazidime, cefepime, imipenem, cefoperazone/sulbactam and piperacillin/tazobactam in Escherichia coli (n = 438), Klebsiella pneumoniae (n = 444), Pseudomonas aeruginosa (n = 210) and Acinetobacter baumanni (n =200) were determined with E-test in a multicenter surveillance study (HITIT-2) in 2007. ESBL production in Escherichia coli and K. pneumoniae was investigated following the CLSI guidelines. Overall 42.0% of E.coli and 41.4% of K. pneumoniae were ESBL producers. In E. coli, resistance to imipenem was not observed, resistance to ciprofloxacin and amikacin was 58.0% and 5.5% respectively. In K. pneumoniae resistance to imipenem, ciprofloxacin and amikacin was 3.1%, 17.8% 12.4% respectively. In P. aeruginosa the lowest rate of resistance was observed with piperacillin/tazobactam (18.1%). A. baumanni isolates were highly resistant to all the antimicrobial agents, the lowest level of resistance was observed against cefoperazone/sulbactam (52.0%) followed by imipenem (55.5%). This study showed that resistance rates to antimicrobials are high in nosocomial isolates and show variations among the centers.

WOS: 000371745700019, PubMed ID: 26325175, Successful vaccination policies for protection from invasive pneumococcal diseases (IPD) dependent on determination of the exact serotype distribution in each country. We aimed to identify serotypes of pneumococcal strains causing IPD in children in Turkey and emphasize the change in the serotypes before and after vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) was included and PCV-13 was newly changed in Turkish National Immunization Program. Streptococcus pneumoniae strains were isolated at 22 different hospitals of Turkey, which provide healthcare services to approximately 65% of the Turkish population. Of the 335 diagnosed cases with S. pneumoniae over the whole period of 2008-2014, the most common vaccine serotypes were 19F (15.8%), 6B (5.9%), 14 (5.9%), and 3 (5.9%). During the first 5y of age, which is the target population for vaccination, the potential serotype coverage ranged from 57.5 % to 36.8%, from 65.0% to 44.7%, and from 77.4% to 60.5% for PCV-7, PCV-10, and PCV-13 in 2008-2014, respectively. The ratio of non-vaccine serotypes was 27.2% in 2008-2010 whereas was 37.6% in 2011-2014 (p=0.045). S. penumoniae serotypes was less non-susceptible to penicillin as compared to our previous results (33.7vs 16.5 %, p=0.001). The reduction of those serotype coverage in years may be attributed to increasing vaccinated children in Turkey and the increasing non-vaccine serotype may be explained by serotype replacement. Our ongoing IPD surveillance is a significant source of information for the decision-making processes on pneumococcal vaccination., PfizerPfizer, This study was supported by Pfizer.

PubMedID: 17462962 To highlight the transmission rate and major phylogenetic clades of drug-resistant Mycobacterium tuberculosis isolates, a total of 200 drug-resistant strains isolated in four different regions of Turkey (Marmara n = 81; Mediterranean n = 39; Aegean n = 42; East Anatolia n = 38), were typed by spoligotyping and IS6110-restriction fragment length polymorphism (RFLP). The major spoligotyping-defined shared-types (STs) and corresponding lineages were, ST 41 (22.5%, LAM7-TUR), ST53 (19.5%, ill-defined T super-family), ST 50 (6.5%, Haarlem 3), ST 1261 (4.5%, LAM7-TUR), ST 47 (3.5%, Haarlem 1), as well as two STs that belonged to undefined clades (ST 284, 3%, and ST 2067, 2.5%). The global distribution of major M. tuberculosis lineages among drug-resistant strains was as follows: T super-family (29%), Latin-American & Mediterranean (33.5%), Haarlem (14%), and the S lineage (3%). A high number of strains (n = 29, 14.5%) showed patterns that did not fall within major clades described so far. A combination of spoligotyping and IS6110-RFLP fingerprinting methods resulted in a final clustering rate of 38.5% and a recent transmission rate of 25.5%. Our results underline the highly diverse nature of drug-resistant tuberculosis in our study population, as well as its ongoing transmission with lineages that are specific to these regions, the most predominant being the LAM7-TUR lineage which shows an enhanced phylogeographical specificity for Turkey. © 2007 Elsevier B.V. All rights reserved. T.Z. received a Ph.D. fellowship awarded by European Union and the Regional Council of Guadeloupe and the International Network of the Pasteur Institutes. The international database project coordinated by Institut Pasteur de Guadeloupe has benefited by an active feedback from various research groups worldwide and currently financed through the European Union and the Regional Council of Guadeloupe, which is greatly acknowledged.

PubMedID: 26266327 This study compares NT proBNP and troponin T levels in umbilical cord arterial blood and postnatal echocardiographic findings for infants of gestational and pregestational diabetic mothers and macrosomic infants. Twenty-seven infants of pregestational diabetic mothers, 61 infants of gestational diabetic mothers and 37 macrosomic infants of nondiabetic mothers were prospectively enrolled in this study along with a control group of 58 healthy infants of mothers without any pregestational or gestational disorders as the control group. All enrollees were born after 34 weeks of gestation. For this study, umbilical cord blood was drawn during delivery to determine NT proBNP and troponin T levels. Echocardiography was performed 24–72 h after the delivery. Umbilical cord troponin T and NT proBNP levels were found to be higher in the diabetic and macrosomic groups than in the control group (all of them p 6.1 %) metabolic control. In the good and suboptimal metabolic control diabetic groups, NT proBNP levels were also positively correlated with interventricular septum thickness (r = 0.536 and r = 0.576, respectively, p

PubMedID: 27530838 The aim of this study was to investigate the epidemiological and molecular features of clinical meticillin-resistant Staphylococcus aureus (MRSA) isolates in Turkey. MRSA isolates were collected from six regions of Turkey. The mecA and nuc genes were detected by PCR. Antimicrobial susceptibilities were determined by the disk diffusion method. Staphylococcal cassette chromosome mec (SCCmec) and staphylococcal protein A (spa) typing were performed by the sequencing method for 270 randomly selected MRSA isolates. The US Centers for Disease Control and Prevention (CDC) definition was used for epidemiological diagnosis of community-associated MRSA (CA-MRSA). Resistance rates of MRSA to ciprofloxacin, gentamicin, clindamycin, erythromycin, rifampicin, trimethoprim/sulfamethoxazole and tetracycline were 93.4%, 81.2%, 38.5%, 57.8%, 93.9%, 1.1% and 93.1%, respectively. The most frequent SCCmec type was SCCmec III (91.1%). SCCmec type IV was found in 5.2% of the isolates. The most frequent spa type was t030 (81.1%). Five isolates were CA-MRSA if only the epidemiological definition was used (5/725; 0.7%). Two isolates were defined as CA-MRSA both by epidemiological features and SCCmec typing (2/270; 0.7%). Of 14 SCCmec type IV isolates, 12 were not defined as CA-MRSA by epidemiological features. In conclusion, this is the most comprehensive multicentre study in Turkey investigating MRSA using both epidemiological and genotypic features. The CA-MRSA rate is low in Turkey. Combined use of epidemiological and genotypic methods is the most accurate approach for the diagnosis of CA-MRSA. © 2016, Elsevier Ltd. All rights reserved. Firat University Scientific Research Projects Management Unit This work was supported by the Scientific Research Unit of Kocaeli University (Kocaeli, Turkey) [2005/3].

The aim of the present study is to investigate the types of healthcare-associated infections (HC-AIs) caused by Acinetobacter baumannii and the related antibiotic susceptibility patterns as well as the genotypic characteristics of the Acinetobacter baumannii isolates from our center. Sixty-nine Acinetobacter baumannii isolates originating from various samples collected from 69 pediatric patients during their hospital stays were included in the study. The types of healthcare-associated infections caused by these isolates were evaluated, and the antibiotic susceptibility pattern and the genotypic characteristics of the isolates were determined using the pulsed-field gel electrophoresis (PFGE) method. Fifty of the 69 children were observed to have HC-AIs, and 19 children had Acinetobacter baumannii colonization. Healthcare-associated pneumonia (58%) was the most common type of these infections. The rate of carbapenem resistance was found as 91.3%, while tigecycline resistance was found as 18.84%. No colistin resistance was observed in any of the isolates. A total of 10 groups, comprising eight major and two minor groups, were determined using the pulsed-field gel electrophoresis method. Acinetobacter baumannii isolates are the leading cause of healthcare-associated infections, and they show high rates of multidrug antibiotic resistance. Molecular epidemiological evaluation using PFGE plays an important role in preventing healthcare-associated infections.

PubMedID: 25595166 Background: Nosocomial infections caused by Carbapenem-resistant Klebsiella pneumoniae (CRKP) are increasing. Our aim in this study was to investigate the risk factors of CRKP infections. Material/Methods: A retrospective cohort study was performed between 1 January and 31 December 2012 in ICU patients. Data was taken from the hospital infection control database for CRKP. The clinical samples collected from the patients were tested by an automatized system and disk diffusion. SPSS software v11.5 was used for statistical analysis. Results: Totally, 105 Klebsiella pneumoniae isolates were found in 2012 and the carbapenem resistance rate was 48%. The first episode of infection was taken into risk factor analysis. Of the 98 patients, 61 (62.2%) were male and the mean and median ages were 30.4±29.8 and 25 (0–93). The length of stay was longer in the resistant group (p=0.026). Mortality was 48% in the whole group and similar between groups (p=0.533). There was a relationship between meropenem and third-generation cephalosporin use and resistance (OR 3.244 (1.193–8.819) and OR: 3.590 (1.056–12.209). The other risk factors in univariate analysis were: Immunosuppression OR: 2.186 (1.754–2.724), nasogastric catheter OR: 3.562 (1.317–9.634), peripheral arterial catheter OR: 2.545 (1.027–6.307), and being admitted to the neurosurgical unit OR: 4.324 (1.110–16.842). The multivariate analysis showed use of third-generation cephalosporin OR: 4.699 (1.292–17.089), nasogastric catheter use OR: 3.983 (1.356–11.698), and being admitted to neurosurgical ICU OR: 4.603 (1.084–19.555) as independent risk factors. Conclusions: Restriction of third-generation cephalosporin and carbapenem use and invasive procedures, along with infection control precautions and disinfection policies, may be effective in reducing the carbapenem resistance in ICUs. © Med Sci Monit, 2015.

Kandidemi yüksek mortalite ile seyreden ciddi bir klinik tablodur. Son yıllarda Candida infeksiyonlarının epidemiyolojisi ve tedavide kullanılan antifungallerle ilgili önemli değişiklikler ortaya çıkmıştır. Bu çalışmada kan kültürlerinden izole edilen Candida türlerinin tanımlanması ve bunların amfoterisin B, kaspofungin, flukonazol, flusitozin ve vorikonazole duyarlılıklarının retrospektif olarak araştırılması amaçlanmıştır.Laboratuvarımıza Ocak 2013-Aralık 2014 döneminde gönderilen kan kültürlerinde tespit edilen maya üremeleri konvansiyonel yöntemler, germ tüp ve VITEK 2 Compact (bioMérieux, Fransa) otomatize identifikasyon sistemi ile tiplendirilmiş ve antifungal duyarlılıkları VITEK 2 Compact sistemi ile belirlenmiştir.İzole edilen 280 Candida suşunun 95'i (% 33.9) Candida parapsilosis, 77'si (% 27.5) Candida albicans, 45'i (% 16) Candida tropicalis, 27'si (% 9.6) Candida glabrata, dokuzar tanesi (% 3.2) Candida kefyr ve Candida lusitaniae, beşi (% 1.7) Candida krusei, dörder tanesi (% 1.4) Candida famata ve Candida sphaerica, ikisi (% 0.7) Candida dubliniensis, birer tanesi de (% 0.3) Candida haemulonii, Candida norvegensis ve Candida pelliculosa olarak tanımlanmıştır. Antifungal duyarlılık yorumlamaları C.albicans, C.parapsilosis, C.tropicalis, C.glabrata, C.krusei olarak izole edilen 249 izolat için yapılmıştır. Antifungallere dirençli Candida türlerinin saptandığı çalışmamızda, üreme saptanan kan kültürlerindeki Candida türlerinin tanımlanmasının ve antifungal duyarlılıklarının bildirilmesinin, tedaviyi yönlendirmek için önemli olduğu sonucuna varılmıştır Candidemia is a serious clinical presentation with a rather high mortality. Over the last years, there have been important changes in the epidemiology of Candida infections and antifungal agents used to treat these infections. In this study, the identification of the Candida species isolated from blood cultures and investigation of their susceptibilities against amphotericin B, caspofungin, fluconazole, flucytosine and voriconazole retrospectively were aimed. Yeasts detected from blood cultures in our laboratory between January 2013 and December 2014 were identified by conventional methods, germ tube and VITEK 2 Compact (bioMérieux, France) automated identification system and susceptibilities to antifungal agents were determined by VITEK 2 Compact System. Among 280 Candida spp., strains isolated, 95 (33.9 %) were identified as Candida parapsilosis, the others were identified as follows: 77 (27.5 %) Candida albicans, 45 (16 %) Candida tropicalis, 27(9.6 %) Candida glabrata, nine (3.2 %) Candida kefyr, nine (3.2 %) Candida lusitaniae, five (1.7 %) Candida krusei, four (1.4 %) Candida famata, four (1.4 %) Candida sphaerica, two (0.7 %) Candida dubliniensis, one (0.3 %) Candida haemulonii, one (0.3 %) Candida norvegensis and one (0.3 %) Candida pelliculosa. Interpretation of antifungal susceptibility tests of C.albicans, C.parapsilosis, C.tropicalis, C.glabrata, C.krusei isolates were made to 249 as described. As a result of our study, in which Candida strains resistant to antifungal agents were isolated, identification to species level and determining antifungal susceptibilities of Candida species isolated from blood cultures is concluded to be important to guide treatment.

The aim of this study is to investigate the existence of extended-spectrum beta-lactamase (ESBL) in nosocomial Gram-negative bacteria isolates and to compare different test methods that detecting ESBL. The strains producing the largest quantities of these enzymes are Klebsiella pneumoniae (K. pneumoniae), Klebsiella spp., and Escherichia coli (E. coli) The aim of this study is to investigate the existence of extended-spectrum beta-lactamase (ESBL) in nosocomial Gram-negative bacteria isolates and to compare different test methods that detecting ESBL. The strains producing the largest quantities of these enzymes are Klebsiella pneumoniae (K. pneumoniae), Klebsiella spp., and Escherichia coli (E. coli)

The number of nosocomial infections caused by Acinetobacter spp. has increased in recent years. In this study, we evaluated 80 patients (male 70% and, mean age of all patients 38.8 ± 12) with nosocomial acinetobacter infections. Fifty three (66.3%) of 80 strains identified by Sceptor were found to be as Acinetobacter baumannii and 27 (33.7%) strains to be as A. lwoffii. All Acinetobacter spp. were multidrug resistant. Quinolone and carbapenem resistance were 60.4% and 15.1% for A. baumannii, and 44.4% and 22.2% for A. lwoffii, respectively. Nosocomial Acinetobacter infections occurred after a mean (± SD) hospitalization of 14 ± 8.8 days. Most of infections (61.3%) were acquired in an intensive care and oncology ward. Of all patients, 76 (95%) had multiple risk factors. Nosocomial infections were as follows: pneumonia in 32 (40.8%), urinary tract infection in 16 (20%), wound infection in 14 (17.5%), bacteremia in 8 (10%), meningitis in 5 (6.3%), catheter infection in 3 (3.8%) and peritonitis in 2 (2.5%) of the patients. Acinetobacter infections caused or contributed to death of 13 (16.3%) patients.

Amaç: Enterokoklarda son yıllarda antimikrobik ajanlara karşı artan oranda direnç gözlenmektedir. Bu çalışmanın amacı, hastanemizde yatarak tedavi gören hastaların idrar kültürlerinden izole edilen enterokok türlerini ve antibiyotik direnç oranlarını belirlemektir.Gereç ve Yöntem: Bu çalışmada Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi'nde yatarak tedavi edilen hastaların Ocak 2012-Nisan 2014 arasında idrar örneklerinden izole edilen, toplam 536 enterokok suşunun tiplendirilmesi yapılarak, çeşitli antibiyotiklere direnç oranları belirlenmiştir. Enterokok suşlarının identifikasyonu ve antimikrobiyal duyarlılıkları otomatik Vitek-2 sistemi (BioMérieux, Fransa) ile yapılmıştır.Bulgular: İzole dilen suşların 277 (%51.6)'si Enterococcus faecalis, 249 (%46.4)'u Enterococcus faecium, 5 (% 0.9)'i Enterococcus avium, 2 (%0.3)'si Enterococcus durans, 2 (%0.3)'si Enterococcus gallinarum, 1 (%0.1)'i Enterococcus hirae olarak tanımlanmıştır. Trimetoprim/sulfametoksazol'e %98.1, klindamisine %97, ampisiline %84.2, eritromisine %83.2, imipeneme %83.2, tetrasikline %73.3, siprofloksasine %66.6, moksifloksasine %65.1, vankomisine %14.7, teikoplanine %14.3, linezolide %4.8 ve tigesikline %0.3 oranında direnç gözlenmiştir. Yüksek düzey aminoglikozit direnci yalnızca gentamisin için %9.3, yalnızca streptomisin için %17.5 olarak belirlenmiştir.Sonuç: Bu çalışmada, glikopeptit dirençli enterokok suşları saptanmıştır. Hastanemizde saptanan vankomisin ve teikoplanin direnci, bu antibiyotiklerin enterokok enfeksiyonlarında dikkatli kullanılmasının gerektiğini göstermektedir. Objective: In recent years, enterococci have become increasingly resistant to a wide range of antimicrobial agents. The aim of this study was to identify the species isolated from the urine cultures of hospitalized patients at Cukurova University Medical Faculty Balcalı Hospital, Adana, Turkey. and determine antimicrobial susceptibility rates of enterococcus strains.Materials and Methods: In this study, a total of 536 enterococcus strains isolated from the urine cultures of the patients hospitalized, and treated in Balcalı Hospital of Çukurova University Faculty of Medicine between January 2012 and April 2014 were typed and antibiotic resistance rates of these isolated were determined Identification and antibiotic susceptibility testing of the enterococci strains were performed using Vitek-2 automated system (BioMérieux, France).Results: Of these isolated strains 277 (51.6%) were identified as Enterococcus faecalis, 249 (46.4%) as Enterococcus faecium, five (0.9%) as Enterococcus avium, two (0.3%) as Enterococcus durans, two (0.3%) as Enterococcus gallinarum and one (0.1%) as Enterococcus hirae. The rates of resistance were 98.1% to trimethoprim/sulfamethoxazole, 97% to clindamycin, 84.2% to ampicillin, 83.2% to erythromycin, 83.2% to imipenem, 73.3% to tetracycline, 66.6% to ciprofloxacin, 65.1% to moxifloxacin, 14.7% to vancomycin, 14.3% to teicoplanin, 4.8% to linezolid and 0.3% to tigecycline. High level aminoglycoside resistance was detected as 9.3 % for only gentamicin and 17.5% for only streptomycin.Conclusion: In this study, glycopeptide resistant enterococcus strains were detected. Thus,resistance to vancomycin and teicoplanin detected in our hospital demonstrates that these antibioticst should be used cautiously in the treatment of enterococcal infections in our center.

Adult tuberculous meningitis is an extra-pulmonary form of tuberculosis which, because of a rapid course and neurological sequela, leads to high morbidity and mortality. For this reason, an early diagnosis is important but is not always possible. The aim of this study, which was carried out between 1991-1995, was to evaluate the factors affecting the prognosis of diseases in patients which had been diagnosied as tuberculous meningitis using the patients history, clinical picture, and laboratory and radiological findings. Fifty nine percent of the patients were between 25-45 years of age. The rate of mortality in these patients 47% and when they were admitted to the hospital, 62.5% were in the second stage of the disease. In 15 (88.2%) of all patients, the symptoms had occurred 2 weeks or more before hospitalization. In the microscobic examination of CSF of 5 (29.4%) of the patients, acid fast bacilli were seen. However, M. tuberculosis grew in the cultures of CSF of only 2 of these. Evidence of active or previous pulmonary tuberculosis was found in 4 (23.5%) of our patients. Ventriculoperitoneal shuts were placed in 3 out of 8 patients who developed hydrocephalus. Multipl tüberculomas which decreased with antituberculous treatment were detected in 2 patients during treatment. In conclusion, in patients with tuberculous meningitis, the most important factors affecting the prognosis is the time between the development of symptoms and treatment as well as the neurologic phase.

PubMedID: 28205271 Background: Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. Methods: The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems. The laboratory turnaround time for individual tests, total delay time in the sample reception area, and percentage of steps involving risks of medical errors and biological hazards in the overall process are measured. Results: The pre-analytical process in the reception area was improved by eliminating 3 h and 22.5 min of non-value-adding work. Turnaround time also improved for stat samples from 68 to 59 min after applying Lean. Steps prone to medical errors and posing potential biological hazards to receptionists were reduced from 30% to 3%. Conclusion: Successful implementation of Lean Six Sigma significantly improved all of the selected performance metrics. This quality-improvement methodology has the potential to significantly improve clinical laboratories. © 2017 Wiley Periodicals, Inc.

WOS: 000374876700187 …

Serum free beta 2-microglobulin (b2M) level has been regarded as an independent biomarker in several cancers, and has traditionally been analyzed using methods such as Immunonephelometry on specialized analyzers. It is now possible to perform this test on clinical chemistry analyzers, using immunoturbidimetry. The aim of this study was to compare these two methods, for measuring serum b2M level. Fourty three samples which were randomly chosen from sera of patients with various malignant conditions were analyzed for serum b2M level, both by immunonephelometric method in Beckman Immage 800 (Beckman Coulter Inc., CA, USA) nephelometer, and by immunoturbidimetric method in Beckman UniCel DXC 800 Synchron (Beckman Coulter Inc., CA, USA) auto-analyzer. Method comparison demonstrated good agreement between the immunonephelometric and immunoturbidimetric b2M testing, in which we found good correlation (r=0.973) and high accuracy (slope=1.009). As a conclusion, Beckman UniCel DXC 800 Synchron immunoturbidimetric b2M assay is suitable for routine use, and correlates well with representative immunonephelometric assays on the Beckman Immage 800 analyzer. The ability to perform specific protein analyses such as b2M on an integrated clinical chemistry/immunoassay system, can allow consolidation of testing on a single platform and results in improved laboratory operations efficiency. It is thought that immunoturbidimetric method can be used safely in the routine screening of serum b2M level, for different types of malignancies

Necrotizing enterocolitis (NEC) is the most common gastrointestinal disease in neonatal intensive care units. Although the pathogenesis of NEC remains unclear, evidence suggests that infections, especially bacterial infections, may play an important role. Viral infections may also result in NEC. Several outbreaks of NEC associated with rotaviruses have been described previously.To investigate the association between rotavirus (RV) and serum interleukin (IL)-6 and IL-8 levels in infants with NEC.RV infections were prospectively studied using antigen detection in the stools of 31 infants with NEC. Additionally, serum levels of IL-6, IL-8 and tumour necrosis factor-alpha were tested using micro-ELISA at 0 h and 48 h after diagnosis of NEC.Fecal specimens from 13 infants were positive, while fecal specimens from 18 infants were negative for RV according to antigen detection (RV+ and RV- groups, respectively). The mortality rate and the severity of NEC were not significantly different between the RV+ and RV- groups. IL-6 levels at 0 h and 48 h after diagnosis of NEC in RV+ infants were lower compared with RV- infants, while IL-8 levels were greater at 0 h and 48 h after diagnosis of NEC in RV+ infants compared with RV- infants.A high prevalence of RV infection in neonates with NEC was found. Decreased IL-6 levels and increased IL-8 and tumour necrosis factor-alpha levels in RV+ neonates with NEC suggests a role for RV in NEC.L’entérocolite nécrosante (ECN) est la principale maladie gastro-intestinale observée dans les unités de soins intensifs néonatals. Même si la pathogenèse de l’ECN demeure nébuleuse, les données probantes indiquent que les infections, notamment les infections bactériennes, peuvent y jouer un rôle important. Les infections virales peuvent également provoquer une ECN. Plusieurs éclosions d’ECN associées à des rotavirus ont été décrites par le passé.Explorer l’association entre le rotavirus (RV) et les taux d’interleukine sérique (IL)-6 et IL-8 chez les nourrissons ayant une ECN.Les chercheurs ont étudié les infections à RV de manière prospective au moyen de la détection des antigènes dans les selles de 31 nourrissons atteints d’une ECN. Ils ont également testé les taux sériques d’IL-6, d’IL-8 et de facteur de nécrose tumorale alpha au moyen du test micro-ELISA immédiatement après le diagnostic d’ECN, puis 48 heures plus tard.Les échantillons fécaux de 13 nourrissons étaient positifs, tandis que ceux de 18 nourrissons étaient négatifs au RV d’après la détection des antigènes (groupe RV+ et groupe RV−, respectivement). Le taux de mortalité et la gravité de l’ECN ne différaient pas de manière significative entre le groupe RV+ et le groupe RV−. Les taux d’IL-6 immédiatement après le diagnostic d’ECN et 48 heures plus tard chez les nourrissons du groupe RV+ étaient inférieurs à ceux des nourrissons du groupe RV−, tandis que les taux d’IL-8 étaient plus élevés immédiatement après le diagnostic d’ECN et 48 heures plus tard chez les nourrissons du groupe RV+ que chez ceux du groupe RV−.Les chercheurs ont décelé une forte prévalence d’infection à RV chez les nouveau-nés ayant une ECN. Les taux d’IL-6 moins élevés et d’IL-8 et de facteur de nécrose tumorale alpha plus élevés chez les nouveau-nés du groupe RV+ ayant une ECN laissent supposer que le RV joue un rôle dans l’ECN.

WOS: 000291147300019, PubMed ID: 21508171, Before use of the pneumococcal conjugate vaccine PCV7 became widespread in Turkey, 202 invasive pneumococcus isolates were analyzed. The most common serotypes were 19F and 6B. In children, Wyeth-Turkey [0887X1-4439], This study was supported by an unrestricted research grant, 0887X1-4439, from Wyeth-Turkey.