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Objective: Enterococci are the second most common cause of nosocomial urinary tract and wound infections, also third most common cause of nosocomial bacteremia. Currently, especially vancomycin-resistant enterococci (VRE) are one of the significant pathogens that cause nosocomial infections and increase mortality, morbidity, and healthcare costs. Therefore prevention and control of the nosocomial VRE outbreaks and epidemiological analysis of the infection are important. Pulsed-Field Gel Electrophoresis (PFGE) is accepted as a “gold standard” method in the molecular epidemiological analysis of enterococcal infections. The aims of this study are to determine the clonal relationship among the nosocomial enterococcal isolates and the rate of cross-contamination between them. Method: Thirty-six Enterococcus strains isolated from hospitalized patients with nosocomial infection in different clinics of Dicle University Hospital between November 2010 and June 2012 were included in this study. A total of 36 isolates were obtained from various clinical samples including urine (n=18), blood (n=6), bronchoalveolar lavage (BAL) fluid (n=5), wound biopsy sample (n=5), vaginal smear (n=1) and catheter tip (n=1). Nine of the thirty-six isolates were VRE. Isolation and identification of the isolates were conducted in the OZET Amac: Enterokoklar hastaneden kaynaklanan uriner

Brucellosis is a zoonotic infectious disease that can affect many organs and systems and leads to very different clinical circumstances. Brucellosis is rare in association with various infectious agents. Fascioliasis is a zoonotic disease caused by Fasciola hepatica, popularly referred to as a large leaf-shaped liver fluke. This case is a 39-year-old male patient, and his complaints began a week ago, which were chills, fever, abdominal pain, nausea, vomiting, weakness, sweating, and widespread pain. The patient was considered brucellosis in the preliminary diagnosis. Rose Bengal test and Wright test (1/640) were detected as positive. Due to patients having elevated liver enzymes, abdominal ultrasound was taken. A liver lesion was seen with abdominal ultrasound. So, abdominal computed tomography (CT) was taken. The CT result report came in the form that at the left lobe of the liver segment 2, largely necrosis that showed no contrast enhancement, approximately 61x63 mm in size (compatible with fascioliasis) is viewed. The patient's IHA test results, required for fascioliasis, were detected as 1/320 positive. Especially for zoonotic diseases in areas with high endemicity, it should be considered that more than one infectious agent can be present together in high-risk patients.

Staphylococcus species are one of the major causes of bacterial bloodstream infections. Multi-resistant staphylococci infections are major therapeutic problems. This study was aimed to detect methicillin, linezolid and vancomycin susceptibilities of Staphylococcus isolates. A total of 870 Staphylococcus strains isolated from blood cultures of hospitalized patients with BSI. Antimicrobial susceptibilities of methicillin, linezolid and vancomycin were detected according to the Clinical and Laboratory Standards Institute (CLSI). A total of 771 (88.6%) isolates were coagulase-negative staphylococci (CoNS). 700 (80.5%) isolates were methicillin-resistant (MR) and 170 (19.5%) were methicillin-susceptible (MS). All the MS isolates were also susceptible to linezolid. However 15 (1.7%) of MR strains were resistant to linezolid. The minimum inhibitory concentration range for the linezolid-resistant isolates by Etest was 6-32 µg/mL. The difference between linezolid susceptibilities for MS and MR staphylococci was not quite statistically significant (p = 0.052). There was no statistically significant difference between S. aureus and CoNS isolates for linezolid susceptibility. All of the isolates were susceptible to vancomycin. In conclusion, linezolid is currently an efficient option for the treatment of methicillin-resistant staphylococci infections.

Anthrax is a rare disease cause by Bacillus anthracis, a Gram-positive, rod-shaped endospore-forming capsuled bacterium. Anthrax is manifest in three primary forms: cutaneous, respiratory, and gastrointestinal. Cutaneous anthrax accounts for approximately 95% of all cases of anthrax in humans.In the present study, we evaluated the clinical diagnosis and treatment of cutaneous anthrax, a rare disease that nonetheless remains a serious healthcare problem in developing countries.The complete medical records of patients diagnosed with cutaneous anthrax between January 2001 and December 2012 were examined in a retrospective manner. Cutaneous anthrax was diagnosed by the identification of typical anthrax lesions and/or the presence of Gram-positive-capsuled bacillus after staining with Gram stain and methylen blue in pathology samples obtained from these lesions and the presence of characteristic scarring with a history of severe swelling, black eschar, and positive response to treatment form the basis of diagnosis in cases where cultures were negative for the presence of bacillus.A total of 58 patients were admitted to the hospital with cutaneous anthrax between January 2001 and December 2012. This included 32 (55.2%) males and 26 (44.8%) females, with an age range of 15-82 years and a mean age of 38 ± 13.8 years. The incubation period for the infection ranged between 1 and 20 d (mean 3.7 ± 1.4 d). The most common symptoms at the time of hospital referral were swelling, redness, and black eschar of the skin. The most common lesion site was the hand and fingers (41.3%). Isolated of bacteria was used to diagnose the disease in six cases (23.8%), detection of Gram-positive bacillus in samples of characteristic lesion material was used in seven (28.5%) cases, and the presence of a characteristic lesion was the sole diagnostic criteria in 45 (77.6%) cases. Treatment consisted of penicillin G (12 cases), ampicillin-sulbactam (30 cases), Cefazolin (12 cases), or ciprofloxacin (4 cases).Although the prevalence of anthrax is a decreasing worldwide, it remains a significant problem in developing countries. Rapid identification of the signs and symptoms of cutaneous anthrax is essential for effective treatment. Early supportive treatment and appropriate antimicrobial measures are necessary to address this potentially life-threatening disease.

Introduction: This study investigated the seroprevalence of hepatitis B virus surface antigen (HBsAg), antibody against hepatitis C virus (anti-HCV), antibody against human immunodeficiency virus type 1/2 (anti-HIV 1/2), and antibody against Treponema pallidum (anti-Treponemal or syphilis antibody) in healthy volunteer blood donors, and assessed their distribution according to the years and genders. Methodology: HBsAg, anti-HCV, anti-HIV ½, and syphilis screening results of a total of 266,035 healthy volunteer blood donors who had been admitted for blood donation to the Regional Blood Center of Dicle University Hospital between January 2000 and December 2010 were evaluated, retrospectively. HBsAg, anti-HCV, and anti-HIV 1/2 screening were performed using a fully automated device with the microparticle enzyme immunoassay method (MEIA). Syphilis screening was performed by Rapid Plasma Reagin (RPR) carbon test between January 2000 and December 2009, and by using a fully automated device with the MEIA method between January 2010 and December 2010. Results: Of 266,035 healthy volunteer blood donors, 259,384 (97.5%) were male and 6,651 (2.5%) were female. Statistically, there was not any significant difference between male and female genders for HBsAg, anti-HCV and syphilis seropositivities (P = 0.729, P = 0.748, and P = 0.861, respectively). HBsAg was found to be positive in 8,422 (3.17%), anti-HCV in 1,703 (0.64%), anti-HIV 1/2 in one (0.0004%) of 266,035 healthy volunteer blood donors, and syphilis antibody with RPR in 166 (0.07%) of 246,341 healthy volunteer blood donors. Conclusion: Blood donor forms should be carefully tailored to improve the identification of possible risks of transfusion-transmitted infections.

To investigate antibacterial and antifungal effectiveness of orthophenylphenol (Fumispore, LCB, La Salle, France) with a new administration method in healthcare environments. Materials and methods: This study was performed in 3 units of the Dicle University Hospital. Surface swab and ambient air samples were collected just before the application of Fumispore and 6 h later. All samples were inoculated onto plate count agar and Sabouraud dextrose agar. The total aerobic colony count (ACC) was determined by using the standard method based on quantitative bacterial measurement. Results: In total, 30 surface swabs and 6 ambient air samples were collected. The mean values of the total ACC were determined on surface swabs: 12.1 colony CFU/cm2 for total microorganisms and 2.9 CFU/cm2 for fungi before application, and 1.6 CFU/cm2 for total microorganisms and 0.4 CFU/cm2 for fungi after application. The mean values of the total ACC were detected in ambient air samples: 258 CFU/m3 for total microorganisms and 208 CFU/m3 for fungi before application, and 20 CFU/m3 for total microorganisms and 15 CFU/m3 for fungi after application. Conclusion: The total ACC values obtained before and after applications have shown that orthophenylphenol (Fumispore) is suitable for adequate disinfection in healthcare environments.

In this study, our aim is to compare the efficacy of different topical antibacterial agents in a rat model contaminated with a multi drug resistant (MDR) standard Acinetobacter baumannii strain. The study was carried out on 40 Sprague-Dawley rats of 250-300 g each. For the purposes of this study, the rats were divided into 5 groups, with 8 rats in each group: Group 1 control; Group 2 silver sulfadiazine; Group 3 mupirocin; Group 4 Acticoat group; and Group 5 octenidine dihydrochloride group. Following to the formation of the full-thickness burn areas in rats, the MDR A. baumannii standard strain was inoculated into the burned area. The rats in all the groups were sacrificed at the end of the 10th day and subjected to histopathological and microbiological evaluation. In the histopathological evaluation, the lowest inflammatory cell response and bacterial density in the eschar and muscle tissues were observed in the Acticoat group. While these results were found to be statistically significant compared to the silver sulfadiazine group, only the bacterial density in the muscle tissue was found as significant in comparison to the mupirocin and octenidine groups. In the microbiological evaluation, the lowest growth in the muscle tissue culture among all the groups was observed in the Acticoat group. The growth in the eschar tissue culture was significantly lower in the Acticoat and octenidine groups in comparison to the silver sulfadiazine group. At the end of the study, it has been observed that Acticoat was effective both in eschar and muscle, while octenidine was effective in eschar tissues in a rat burn model contaminated with MDR A. baumannii.

Amaç: Bu çalışmanın amacı, klinik örneklerden izole edilen stafilokok suşlarında fusidik asidin in vitro etkinliğinin araştırılmasıdır. Gereç ve yöntem: Çalışmaya çeşitli klinik örneklerden izole edilen 41 koagülaz negatif stafilokok (KNS) izolatı ile 18 Staphylococcus aureus suşu dahil edildi. Stafilokok izolatları besiyeri yüzeyindeki koloni morfolojisi, gram boyama, katalaz ve koagülaz testleri gibi konvansiyonel yöntemlerle identifiye edildi. İzolatların antimikrobiyal duyarlılıkları “Clinical and Laboratory Standards Institute (CLSI)” önerileri doğrultusunda Kirby-Bauer disk difüzyon yöntemi kullanılarak çalışıldı. Bulgular: İzole edilen S.aureus suşlarının % 72’si metisiline duyarlı (MSSA), % 28’i metisiline dirençli (MRSA) olarak tanımlandı. MSSA ve MRSA suşlarının fusidik asit duyarlılık oranları arasındaki fark istatistiksel olarak anlamlı bulunmadı (p=0.305). İzole edilen KNS’lerin % 29’u metisiline duyarlı (MS-KNS), % 71’i metisiline dirençli (MRKNS) olarak tanımlandı. MR-KNS ve MS-KNS suşlarının fusidik asit duyarlılık oranları arasında istatistiksel olarak anlamlı fark yoktu (p=0.490). Ancak, KNS ve S.aureus suşlarının fusidik asit duyarlılık oranları arasındaki fark istatistiksel olarak anlamlıydı (p, Objectives: The aim of this study was to investigate in vitro susceptibility of fusidic acid to clinic isolates of staphylococci. Materials and methods: The forty-one coagulase negative staphylococci (CNS) and 18 Staphylococcus aureus strains isolated from various clinical specimens were included in this study. Staphylococci isolates were identified by conventional methods such as colony morphology onto medium, gram staining, catalase and coagulase tests. According to “Clinical and Laboratory Standards Institute (CLSI)” criteria, antimicrobial susceptibility testing of isolates was performed by Kirby-Bauer’s disk diffusion method. Results: The seventy-two percent of the isolated S.aureus were defined as methicillin sensitive-S.aureus (MSSA), 28% of the isolated S.aureus were defined as methicillin resistant-S.aureus (MRSA). The difference among fusidic acid susceptibility rates of MSSA and MRSA strains was not statistically significant (p=0.305). The twenty-nine percent of the isolated CNS were defined as methicillin sensitive- CNS (MS-CNS), 71% of the isolated CNS were defined as methicillin resistant-CNS (MR-CNS). There was no statistically significant difference between MS-CNS and MR-CNS strains for fusidic acid susceptibility rates (p=0.490). But the difference among fusidic acid susceptibility rates of CNS and S.aureus strains was statistically significant (p

Objectives: The aim of this study was to investigate in vitrosusceptibility of fusidic acid to clinic isolates of staphylococci.Materials and methods: The forty-one coagulase negativestaphylococci (CNS) and 18 Staphylococcus aureusstrains isolated from various clinical specimens were includedin this study. Staphylococci isolates were identifiedby conventional methods such as colony morphologyonto medium, gram staining, catalase and coagulasetests. According to “Clinical and Laboratory Standards Institute(CLSI)” criteria, antimicrobial susceptibility testingof isolates was performed by Kirby-Bauer’s disk diffusionmethod.Results: The seventy-two percent of the isolated S.aureuswere defined as methicillin sensitive-S.aureus (MSSA),28% of the isolated S.aureus were defined as methicillinresistant-S.aureus (MRSA). The difference among fusidicacid susceptibility rates of MSSA and MRSA strains wasnot statistically significant (p=0.305). The twenty-nine percentof the isolated CNS were defined as methicillin sensitive-CNS (MS-CNS), 71% of the isolated CNS were definedas methicillin resistant-CNS (MR-CNS). There wasno statistically significant difference between MS-CNSand MR-CNS strains for fusidic acid susceptibility rates(p=0.490). But the difference among fusidic acid susceptibilityrates of CNS and S.aureus strains was statisticallysignificant (p

Background: We evaluated the effects of pneumatic tube system (PTS) transport rates and distances on routine hematology and coagulation analysis. PTS effects on centrifuged blood samples were also examined. Method: The study was completed at Dicle University Hospital, which has the longest pneumatic tube system in Turkey. Blood samples were collected at three different locations within the hospital and an emergency department, and delivered to the central laboratory by the PTS or a human carrier. Samples were transported at different rates and over varying distances. Each specimen’s potassium (K) and lactic dehydrogenase (LDH) levels, in both the serum and plasma, were tracked to monitor hemolysis. Measurements of LDH and K were obtained using heparin or citrate. Result: A positive correlation was observed between distance and hemolysis in serum samples transported at 4.2 m/sec, and at 3.1 m/sec for more than 2200 m (r = 0.774 and r = 0.766, respectively). Distance and hemolysis were also correlated in non-centrifuged samples (r = 0.871). The alterations in plasma LDH and K levels at different rates and PTS lengths were not statistically significant. Conclusion: The rate of hemolysis in PTS transported samples, dependent on PTS length and rate, may seriously affect routine tests of noncentrifuged samples. J. Clin. Lab. Anal. 26:66‐69,2012. C � 2012 Wiley Periodicals, Inc.

Objectives: Stool antigen assay has been shown to be as sensitive and specific as culture with isoenzyme analysis and to outperform microscopy for the detection of E.histolytica in endemic area. The aim of the present study is to investigate the presence of E.histolytica by direct microscopic examination and ELISA in stool samples, comparatively. Materials and methods: Between September 2010 and May 2011, a total of 975 stool samples of patients in different age groups were sent to microbiology laboratory of Kızıltepe General Hospital. Native-Lugol method and E.histolytica-specific antigen test (Adhesin Ag, Entamoeba CELISA Path) was applied to all stool samples. Results: E.histolytica/dispar cysts and/or trophozoites were observed in 21 out of 975 (2.2%) stool samples examined by native-Lugol method. In addition, E.histolyticaspecific antigen in 975 stool specimens was investigated by ELISA. E.histolytica-specific antigen was determined in 4 patients which had E.histolytica/dispar cysts and/or trophozoites at direct microscopic examination. Although at direct microscopy of 3 patients E.histolytica/dispar cysts and/or trophozoites not observed, E.histolyticaspecific antigen was found favorable. A total of 7 (0.7%) E.histolytica specific antigen was found in the patient’s stool samples. Patients with E.histolytica-specific antigen were treated. Conclusion: E.histolytica specific antigen in stool samples should be investigated to avoid unnecessary treatment. Amaç: Dışkı örneklerinde antijen testinin, izoenzim analizi ile birlikte kültür kadar duyarlı ve özgül bir test olduğu ve endemik bölgelerde mikroskopik bakıyı safdışı bıraktığı gösterilmiştir. Bu çalışmanın amacı; dışkı örneklerinde direkt mikroskopik bakı ve ELISA yöntemi ile Entamoeba histolytica varlığının araştırılmasıdır. Gereç ve yöntem: Çalışmaya; Eylül 2010-Mayıs 2011 tarihleri arasında Kızıltepe Devlet Hastanesi Mikrobiyoloji laboratuvarına gönderilen, farklı yaş gruplarındaki hastalara ait 975 dışkı örneği dahil edildi. Tüm dışkı örneklerine nativ-Lugol yöntemi ve E.histolytica-özgül antijen testi (Adhesin Ag, Entamoeba CELISA Path) uygulandı. Bulgular: Direkt bakıda nativ-Lugol yöntemi ile incelenen 975 dışkı örneğinin 21’inde (%2.2) Entamoeba histolytica/ dispar kist ve/veya trofozoitleri görüldü. Ayrıca 975 dışkı örneğinde, ELISA yöntemi ile E.histolytica özgül antijeni araştırıldı. Direk mikroskopik bakıda Entamoeba histolytica/dispar kist ve/veya trofozoitleri görülen hastaların sadece 4’ünde E.histolytica özgül antijeninin varlığı tespit edildi. Fakat 3 hastanın direk mikroskopik bakısında Entamoeba histolytica/dispar kist ve/veya trofozoitleri görülmezken E.histolytica özgül antijeni ise pozitif bulundu. Toplam olarak 7 (% 0.7) hastanın dışkı örneğinde E.histolytica özgül antijeninin varlığı tespit edildi. E.histolytica özgül antijeni saptanan olgulara uygun tedavi başlandı. Sonuç: Hastaların gereksiz tedavi almasını önlemek için dışkı örneklerinde E.histolytica özgül antijeninin varlığı araştırılmalıdır.

Objectives: In present study was aimed to investigate the seroprevalences of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among healthcare workers in Mardin Obstetric and Children Hospital between 2008 and 2009. Methods: In sera samples obtained from 180 healthcare workers, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), HCV antibody (anti-HCV) and HIV antibody (anti-HIV) markers were tested by chemiluminescent immunoassay with Advia Centaur (Siemens) autoanalyser. Results: We found HBsAg positive and anti-HBs negative in 2 healthcare workers (1.1%); HBsAg negative and anti-HBs positive in 123 healthcare workers (68.3%); HBsAg negative and anti-HBs negative in 55 healthcare workers (30.6%); 2 healthcare workers (1.1%) anti-HCV antibody positive in 115 (63.3%) girls and 65 (36.7%) boys on the way total 180 healthcare workers. None of these patients found HIV antibody. It was also seen that 107 (59.4%) healthcare workers had anti-HBs positivity due to vaccination and 16 (8.9%) healthcare workers without vaccination. As the HBsAg positivity rate was detected expected low, anti-HBs positivity rate was detected expected high. Conclusion: As a result, healthcare workers are not at risk more than normal population for hepatitis B and C in our hospital. However, standard infection control programs and immunization should be applied for the protection of both patients and healthcare workers., Amaç: Çalışmamızda, 2008 ve 2009 yıllarında Mardin Kadın Doğum ve Çocuk Hastalıkları Hastanesi çalışanlarında hepatit B virüsü (HBV), hepatit C virüsü (HCV) ve insan immün yetmezlik virüsü (HIV) seroprevalansını araştırmayı amaçladık. Yöntem: Toplam 180 hastane çalışanına ait serum örneklerinde; hepatit B yüzey antijeni (HBsAg), hepatit B yüzey antikoru (anti-HBs), hepatit C antikoru (anti-HCV) ve HIV antikoru (anti-HIV) belirteçleri Advia Centaur (Siemens) otoanalizörü ile kemiluminesans immünassay tekniği kullanılarak çalışıldı. Bulgular: Araştırmaya dahil edilen 66\'sı (%36.7) erkek 114\'ü (%63.3) kadın olmak üzere toplam 180 hastane çalışanının; 2\'sinde (%1.1) HBsAg (+)/anti-HBs (-), 123\'ünde (%68.3) HBsAg (-)/anti-HBs (+), 55\'inde (%30.6) HBsAg (-) / anti-HBs (-) ve 2\'sinde (%1.1) anti-HCV (+) olarak belirlenirken çalışanların hiçbirinde anti-HIV antikoru tespit edilmedi. Çalışanların 107\'sinde (%59.4) aşıya bağlı anti-HBs pozitifliği, 16\'sında (%8.9) ise doğal bağışıklığa bağlı anti-HBs pozitifliği olduğu görüldü. HBsAg pozitiflik oranı beklenenden daha düşük düzeyde, anti-HBs pozitiflik oranı ise beklenenden daha yüksek düzeyde bulundu. Sonuç: Hastanemizde görev yapan sağlık çalışanları hepatit B ve C yönünden, normal populasyondan daha yüksek risk altında değildir. Buna rağmen, kan ve vücut sıvıları ile bulaşan enfeksiyonlardan gerek sağlık personelini ve gerekse hastaları korumak amacıyla standart enfeksiyon kontrol programlarına uyulmalı ve gerekli aşılama çalışmaları mutlaka yapılmalıdır.

Objectives: Staphylococci were most prominent factors that responsible for skin, soft tissue and foreign body infections. Gaining resistance to methicillin and various antibiotics in these microorganisms over the years increased morbidity and mortality, especially in hospitalized patients. In such situations number of preferred antibiotics was limited. The aim of this study was to investigate in-vitro susceptibility of fusidic acid to clinic isolates of Staphylococci. Materials and methods: The seventy-seven coagulase negative staphylococci (CNS) and 37 Staphylococcus aureus strains isolated from various clinical specimens were included in this study. Staphylococci were identified with gram stain, catalase and coagulase tests. According to “Clinical and Laboratory Stan dards Institute (CLSI)” criteria, antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Results: The seventy-four percent of the isolated CNS were defined as methicillin sensitive-CNS (MS-CNS), 26% of the isolated CNS were defined as methicillin resistant (MR-CNS). While 40% of MR-CNS was resistant to fusidic acid, fusidic acid resistance was found to be 24% in MS-CNS. In methicilline-sensitive S.aureus strains fusidic acid resistance rate were detected as 13%; and in methicillin-resistant S.aureus strains the rate were 14%. Conclusion: Susceptibility of fusidic acid in Staphylococcus aureus strains were found higher than coagulase-negative staphylococci. Fusidic acid remains as an alternative in the treatment of infections due to staphylococci. J Microbiol Infect Dis 2011;1(1):22-25.

Septic arthritis is a serious medical problem that causes rapidly chronic and irreversible joint damage when diagnosis and treatment are delayed. Although, the bacteria are the most frequent cause of septic arthritis, rarely fungi may be responsible for this disease. We presented here a case of septic arthritis caused by Aspergillus fumigatus, developed in a 65 years-old-male patient with diabetes mellitus. The patient admitted to our hospital with complaints of pain, swelling, redness in the right knee and high fever, which are not exceeding despite using vancomycin and ceftriaxone for 18 days. Imipenem was started to the patient in our hospital. At the end of 7 days because of no regression of patient’s complaints, arthroscopic synovectomy and lavage were performed for the patient’s right knee. Aspergillus fumigatus was isolated from the aspiration biopsy specimen that received during the surgical operation and patient was treated with voriconazole, successfully. J Microbiol Infect Dis 2012; 2(1): 29-32

Aspergillosis is a definition including a wide variety of diseases caused by fungi in the genus Aspergillus. Aspergillosis that occurs especially in neutropenic and immunosuppressive patient is an opportunistic infection with a very high mortality rate. In this study, we presented a case of primary cutaneous aspergillosis that caused in a heart transplant recipient. Thirty-nine-years-old male patient with the complaints of high fever lasting for ten days, redness of the right thigh, swelling, and pain, was admitted to our hospital. By the tissue ultrasonography of right thigh, 3x12 cm in size of septated intensive fluid collection (abscess?) in muscle tissue at a depth of 1.5 cm to the skin surface was reported. The biopsy specimens that were taken from the lesion sent to microbiology and pathology laboratories. The branching septate hyphae were observed in Hematoxylin-Eosin and Gram stained preparations. Aspergillus fumigatus was isolated and identified from the biopsy specimen. The patient\'s symptoms were regressed rapidly and the lesion was improved by surgical debridement and antifungal agent (amphotericin B) therapy. In the light of this case report, we were emphasized that microbiologic examination and culture have an important role for diagnosis of cutaneous aspergillosis., Asperjiloz; Aspergillus genusunda yer alan mantarların meydana getirdiği çok geniş hastalıkları kapsayan bir tanımdır. Özellikle nötropenik ve immünsüpresif hastalarda gelişen aspergillozis çok yüksek mortalite oranına sahip fırsatçı bir enfeksiyondur. Bu makalede kalp nakli yapılan bir hastada meydana gelen primer kütanöz aspergillozis olgusunu sunduk. On günden uzun süren yüksek ateş, sağ uyluğunda şişlik, kızarıklık ve ağrı şikayetleri olan otuz dokuz yaşındaki erkek hasta hastanemize başvurdu. Sağ uyluk ultrasonografi incelemesinde; deri yüzeyinden 1.5 cm derinde kas dokusu içerisinde 3x12 cm boyutlarında septalı yoğun sıvı birikimi (abse?) rapor edildi. Lezyondan alınan biyopsi materyalleri mikrobiyoloji ve patoloji laboratuvarlarına gönderildi. Hematoksilen-Eozin ve Gram boyalı preparatlarda dallanmış septalı hifler görüldü. Biyopsi materyalinden Aspergillus fumigatus izole ve identifiye edildi. Cerrahi olarak debride edilen ve amfoterisin B tedavisi başlanan hastanın semptomları hızla geriledi ve lezyonları iyileşti. Bu olgu sunumunun ışığında; aspergillozisin tanısında mikrobiyolojik inceleme ve kültürün önemli bir role sahip olduğunu vurguladık

Objectives: The aim of this study was to evaluate the sero­positivity of rickettsial infections (rickettsioses) and to assess risky behaviors for rickettsioses in North Anatolia, which have dense tick population. Materials and methods: Blood samples of 409 voluntary participants were collected in a cross-sectional seropreva­lence research in Samsun-Tekkeköy and 171 from Samsun Regional Laboratory, KTÜ Medical Faculty/Clinic of Infection Diseases and Tokat State Hospital to determine regional characteristics and risk factors of rickettsial infections. The total sample size was 580 persons. A standard questionnaire was performed by a face to face interview with participants. The 0-4 age group children were not included. The presence of anti-Rickettsia IgG antibodies was tested in blood samples with Indirect Immunoflourescein Antibody (IFA) method. Results: Spotted fever group anti-Rickettsia IgG antibody seropositivity was detected in 68 (11.7%) blood samples. Contrarily, typhus group anti-Rickettsia IgG antibody se­ropositivity was not found in any participant. With bivariate analyses following variables were found to be significantly correlated with rickettsia seropositivity: education status (p=0.015), age (p=0.001), working in farm (p=0.008), working in garden (p=0.022), agricultural activities (p=0.001), being interested in relaxation activity (p=0.009), animal breeding (p=0.007), milking (p=0.001) and exposure to wild animals (p=0.004). With logistic regression analysis; age [Risk Odds Ratio ‘ROR\'=1.03 (95% GA=1.02-1.05)] and exposure to wild animals [ROR=1.97 (95% GA=1.12-3.46)] were found to be associated with increased seropositivity. Conclusions: Our results supported the existence of rick­ettsial diseases in Turkey. Further seroepidemiological in­vestigations are needed to detect incidence/prevalences of rickettsioses and related risky behaviors in our country., Amaç: Riketsiyal enfeksiyonların (riketsiyoz) seropozitifliğini ve toplumda riketsiyozlar yönünden riskli davranış modelleri­ni belirlemek amacıyla Kuzey Anadolu\'da bir anket uygulan­mış ve seropozitivite araştırması yapılmıştır. Gereç ve Yöntem: Riketsiyozların bölgesel özelliklerini ve bazı risk faktörlerini belirleyebilmek amacıyla; Tekkeköy il­çesinde (Samsun) gerçekleştirilen kesitsel tipteki seropreva­lans çalışmasına ait sağlıklı ve semptomsuz 409 kişinin kan örneği ile Samsun Bölge Hıfzıssıhha Müdürlüğü, Karadeniz Teknik Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları Po­likliniği ve Tokat Devlet Hastanesi\'ne herhangi bir nedenle başvuran 171 gönüllü kişiden kan örnekleri çalışmaya dahil edilmiştir. Örneklem büyüklüğü toplam 580 kişidir. Katılımcı­lara standart anket formu yüz yüze görüşme yöntemi kulla­nılarak uygulanmıştır. 0–4 yaş grubu çocuklar çalışma dışı bırakılmıştır. Serum örneklerinde indirekt immünfloresan an­tikor (İFA) tekniği kullanılarak anti-riketsiya IgG antikor varlığı araştırılmıştır. Bulgular: Altmış sekiz serum örneğinde (%11.7) benekli ateş grubu (BAG) anti-riketsiya IgG antikor pozitifliği saptanmıştır. Tifüs grubu (TG) için antikor pozitifliği bulunamamıştır. İkili analizlerde; eğitim durumu (p=0.015), yaş (p=0.001), tarlada çalışma (p=0.008), bağ-bahçede çalışma (p=0.022), tarım ile uğraş (p=0.001), dinlenme aktivitesi (p=0.009), hayvan bes­leme (p=0.007), süt sağma (p=0.001), yabani hayvan teması (p=0.004) ile seropozitivite arasında istatistiksel olarak anlam­lı ilişki bulunmuştur. Lojistik regresyon sonuç modeline göre; yaş [Risk Odds Ratio ‘ROR\'=1,03 (%95 GA=1.02-1.05)] ve yabani hayvan temasının [ROR=1.97 (%95 GA=1.12-3.46)] seropozitivite olasılığını artırdığı gözlenmiştir. Sonuç: Çalışmamızın sonuçları Türkiye\'de riketsiyal hasta­lıkların mevcut olduğunu göstermektedir. Riketsiyozların ül­kemizdeki varlığının tam olarak belirlenebilmesi ve insidans/prevalans tahminlerinin yapılabilmesi için daha fazla sayıda seroepidemiyolojik çalışmalara ihtiyaç vardır. Ayrıca riketsiyal hastalıklar için risk faktörleri de yeniden değerlendirilmelidir.

Objectives: In recent years, in our country and the world, susceptibility of uropathogenic E.coli strains to commonly used antibiotics in the treatment of urinary tract infections has decreased. That decreased susceptibility has been caused to treatment failure, need to change the empirical treatment, increase in prescription costs, prolongation of hospital stay, increased social costs, increased morbidity and mortality. In this study, determination of susceptibility to different variety of antibiotics and fosfomycin in urinary tract infection isolate E.coli were aimed. Materials and methods: The study included E.coli posi­tive urine samples which had been sent to State Hospi­tal Central Laboratory in Kızıltepe between August 2010 and December 2010. These isolates were obtained from patients who have microscopically 10/mm3 leukocyte in urine. In this study, we tested susceptibility of iso­lated E.coli to FOT (Fosfomycin), CIP(ciprofloxacin), IP (İmipenem), TZP (Piperasilin-Tazobactam), CAZ (Ceftazi­dim). According to CLSI criteria, susceptibility testing was performed by Kirby-Bauer disc diffusion method. Results: E.coli strains isolated from urine samples exam­ined between August 2010 and December 2010, all were susceptible to fosfomisine. The resistance rates of E.coli strains to Ceftazidim, Ciprofloxacin, İmipenem, Piperacil­lin-Tazobactam were found respectively 33.3%, 49.1%, 36.8%, 45.6% (Table 1). Conclusions: Because of the high susceptibility rates of fosfomycin at community-acquired urinary tract infection, it can be preferred to the non-complicated urinary tract infections as an antimicrobial agent., Amaç: Son yıllarda ülkemizde ve dünyada üropatojen E.coli suşlarında üriner sistem infeksiyonu tedavisinde sık kullanılan antibiyotiklere karşı duyarlılıkta azalma gö­rülmektedir. Direnç nedeniyle tedavi yetersizliği ve ampi­rik tedavinin değiştirilmesi ihtiyacı, reçete maliyetlerinde artış, hastanede kalma süresinde uzama, sosyal maliyet, morbidite ve mortalitede artış ortaya çıkmaktadır. Bu ça­lışmada, üriner sistem infeksiyon etkeni olan E.coli\'nin bazı antibiyotiklere ve fosfomisine olan duyarlılığının araştırılması amaçlanmıştır. Gereç ve yöntem: Kızıltepe Devlet Hastanesi Merkez laboratuarına Ağustos 2010-Aralık 2010 tarihleri arasın­da polikliniklerden gelen idrar örneklerinden izole edilen E.coli izolatları çalışmaya alınmıştır. Bu izolatlar idrar mik­roskobisinde 10/mm3 lökositi olup üriner sistem infeksi­yonu düşündüğümüz hastaların idrar kültürlerinden elde edilmiştir. Bu çalışmada üropatojen E.coli infeksiyonların­da FOT (fosfomisin), CIP (Siprofloksasin), IP (İmipenem), TZP (Piperasilin-Tazobactam), CAZ (Ceftazidim)\'in duyar­lılıklarına bakılmıştır. Antibiotik duyarlılıkları CLSI (Clinical Laboratory Standards Institute) önerileri doğrultusunda Kirby-Bauer disk difüzyon yöntemi ile değerlendirilmiştir. Kontrol suşu olarak E.coli ATCC 25922 kullanılmıştır. Bulgular: Ağustos 2010-Aralık 2010 tarihleri arasında in­celenen idrar örneklerinden izole edilen E.coli suşlarının hepsi fosfomisine duyarlı bulunmuştur. Siprofloksasine, İmipenem, Piperasilin-Tazobaktam, Seftazidime karşı di­renç oranları sırasıyla; %33,3, %49,1, %36,8, %45,6 ola­rak belirlenmiştir. Sonuç: Toplum kökenli üriner sistem infeksiyonlarında fosfomisin; yüksek düzey duyarlılık oranları nedeni ile non-komplike üriner sistem enfeksiyonlarında tercih edi­lebilir bir antimikrobiyal ajandır.

Staphylococcus aureus causes serious hospital-acquired (HA) and community-acquired (CA) infections. Skin and soft-tissue infections especially are sometimes caused by strains harbouring Panton-Valentine leukocidin (PVL). PVL belongs to a family of bi-component leukocidal toxins produced by staphylococci. It is a pore-forming toxin encoded by lukF-PV and lukS-PV. A total of 70 S. aureus strains: 38 (54%) methicillin-resistant (MRSA) and 32 (46%) methicillin-susceptible (MSSA), were isolated from patients admitted to Dicle University Hospital (Turkey). Identification of S. aureus and antibiotics-susceptibility testing were performed with PHOENIX 100. PVL genes and mecA genes were detected by polymerase chain reaction. Of the 70 studied strains, 36 ones (51%) were community acquired and 34 ones (49%) were hospital acquired . A total of 38 (54%) strains were positive for mecA (mecA +), of which 32 ones (84%) were HA. Of the mecA − strains, 30 (94%) were CA. Of the 70 studied strains, 12 (17%) strains were PVL+: 8 (22%) of the 36 CA strains and 4 (12%) of the 34 HA strains. Of the 12 PVL+ strains, 4 strains were mecA +. The PVL positivity rate was 25% in MSSA, whereas 10.5% in MRSA. Of the overall PVL+ strains, seven strains were obtained from wounds; four ones from skin abscess; and one from blood culture. Taken together, the obtained results showed a substantial level of PVL genes in the studied region. Although PVL is known as a common virulence factor of CA MRSA, HA MRSA isolates in our study showed a considerable rate of PVL positivity.

Ozcan, Nida/0000-0001-6898-7516; Ozcan, Nida/0000-0001-6898-7516 WOS: 000348931600015 Staphylococcus aureus causes serious hospital-acquired (HA) and community-acquired (CA) infections. Skin and soft-tissue infections especially are sometimes caused by strains harbouring Panton-Valentine leukocidin (PVL). PVL belongs to a family of bi-component leukocidal toxins produced by staphylococci. It is a pore-forming toxin encoded by lukF-PV and lukS-PV. A total of 70 S. aureus strains: 38 (54%) methicillin-resistant (MRSA) and 32 (46%) methicillin-susceptible (MSSA), were isolated from patients admitted to Dicle University Hospital (Turkey). Identification of S. aureus and antibiotics-susceptibility testing were performed with PHOENIX 100. PVL genes and mecA genes were detected by polymerase chain reaction. Of the 70 studied strains, 36 ones (51%) were community acquired and 34 ones (49%) were hospital acquired . A total of 38 (54%) strains were positive for mecA (mecA(+)), of which 32 ones (84%) were HA. Of the mecA(-) strains, 30 (94%) were CA. Of the 70 studied strains, 12 (17%) strains were PVL+: 8 (22%) of the 36 CA strains and 4 (12%) of the 34 HA strains. Of the 12 PVL+ strains, 4 strains were mecA(+). The PVL positivity rate was 25% in MSSA, whereas 10.5% in MRSA. Of the overall PVL+ strains, seven strains were obtained from wounds; four ones from skin abscess; and one from blood culture. Taken together, the obtained results showed a substantial level of PVL genes in the studied region. Although PVL is known as a common virulence factor of CA MRSA, HA MRSA isolates in our study showed a considerable rate of PVL positivity. Dicle University Scientific Research Projects Coordination Office (DUBAP)Dicle University [12-TF-119] This research was supported by the Dicle University Scientific Research Projects Coordination Office (DUBAP) [grant number 12-TF-119].

Musculoskeletal tuberculosis (MT) occurs in 1–3% of patients with tuberculosis, while MT of the chest wall constitutes 1% to 5% of all cases of musculoskeletal MT. They are most frequently found at the margins of the sternum and along the rib shafts. Computed tomography is a useful tool for investigation in the diagnosis of abscess and in determining the extent of an abscess. Antituberculous chemotherapy and surgical excision should be started immediately after the appropriate microbiological and histological samples have been obtained if the clinical suspicion is high. We presented our experience with a 49-year-old woman who had musculoskeletal tuberculosis at the anterior chest wall together with a review of the literature on this subject. Key words: Anterior chest wall, tuberculosis, diagnosis, treatment., Kas-iskelet tüberkülozları, tüm tüberküloz vakalarının %1-3\'ünü oluştururlar ve bunlardan yalnızca %1-5\'i toraks ön duvarında yerleşir. Toraks ön duvarında en sık tutulan yapılar ise sternum kenarı ve kosta gövdesidir. Bilgisayarlı tomografi lezyonların tanımlanmasında ve genişliğinin belirlenmesinde etkilidir. Eğer yüksek klinik şüphe varsa uygun histopatolojik ve mikrobiyolojik örnekler alındıktan sonra, derhal cerrahi eksizyon yapılmalı ve antitüberküloz ilaç tedavisi başlanmalıdır. Bu yazımızda, toraks ön duvarında tüberküloz tanısı alan 49 yaşında kadın hastanın güncel literatür eşliğinde irdelenmesi amaçlanmıştır.

Chryseobacterium indologenes is a non-fermentative Gram-negative bacillus formerly belonging to the Flavobacterium genus. It is widely found in water and soil, also on wet surfaces of the hospital environment. It rarely causes infections and is usually associated with altered immune status or indwelling devices. We present a case of ventriculoperitoneal shunt infection caused by C. indologenes in a premature pediatric patient. A six-month-old male infant with congenital hydrocephalus and ventriculoperitoneal shunt was admitted with complaints of irritability, high fever and projectile vomiting. He was diagnosed as suffering from meningitis based on the clinical symptoms and laboratory findings of cerebrospinal fluid. The ventriculoperitoneal shunt was externalized and cerebrospinal fluid samples were sent for bacterial cultures. The isolated bacterium was identified as C. indologenes by conventional methods and the BD Phoenix™ 100 (Becton Dickinson, MD, USA) fully automated microbiology system. Antimicrobial susceptibility testing was performed by the microdilution method and Kirby-Bauer's disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines. The isolate was found susceptible to ciprofloxacin, levofloxacin, cefoperazone and trimethoprim-sulfamethoxazole, while it was resistant to amikacin, aztreonam, cefepime, ceftazidime, gentamicin, imipenem and ticarcillin-clavulanic acid. The treatment was started with trimethoprim-sulfamethoxazole and cefoperazone-sulbactam The ventriculoperitoneal shunt was then removed. The patient was fully healed after two weeks and discharged. Central nervous system infection is a rare form of C. indologenes infections. The case presented herein may make a useful contribution to the existing literature.

In the context of the substantial increase in antibiotic resistance rates of Acinetobacter baumannii, we aimed to evaluate the susceptibility rate changes of A. baumannii strains for carbapenems. A. baumannii strains isolated from patients diagnosed with healthcare-associated infections between 2007-2010 were included. A total of 127 A. baumannii strains [53 (42%) from the intensive care unit and 74 (58%) from the non-intensive care unit] were isolated. Conventional methods and an automated microbiology system were used for identification. Susceptibility testing was studied by Kirby-Bauer disk diffusion method. In 2007, five of 26 strains, in 2008, 18 of 31, in 2009, 10 of 35, in 2010, and 20 of 35 were obtained from intensive care unit patients. The susceptibility rate for imipenem was 50% in 2007 but 20% in 2010, while for meropenem it was 55% in 2007 but 12% in 2010. Prevention and control of antibiotic resistance among Acinetobacter species needs antibiotic usage restrictions and infection control precautions.

In order to detect the methicillin susceptibility and determine the prevalence of constitutive and inducible clindamycin resistance in Staphylococcus aureus strains, a total of 254 S. aureus isolates, including 139 (54.7%) methicillin-sensitive and 115 (45.3%) methicillin-resistant, were tested for clindamycin and erythromycin by Kirby-Bauer disk diffusion method. The disk diffusion induction test or D-test was performed on erythromycin-resistant and clindamycin-sensitive strains using the disk diffusion method. The erythromycin-resistant and clindamycin-sensitive strains with a D-shaped zone around the clindamycin disk were considered positive for inducible clindamycin resistance. If a strain was found to be both erythromycin-resistant and clindamycin-resistant, it was considered to have constitutive clindamycin resistance. Overall, ten (3.9%) strains, including two methicillin-resistant S. aureus and eight methicillin-sensitive S. aureus, were found to be erythromycin-resistant and clindamycin-sensitive according to the disk diffusion method and all of these strains showed inducible clindamycin resistance by the D-test method. Constitutive clindamycin resistance was detected in 100 of all MRSA strains. In conclusion, the presence of inducible clindamycin-resistant strains may lead to clindamycin treatment failure in patients with S. aureus infection. The D-test method should be used for antimicrobial susceptibility testing of clindamycin.

The importance of oxygen in wound healing and the negative effects of cigarette smoking have been demonstrated in various studies. In this study, our aim was to investigate the effect of hyperbaric oxygen (HBO2) treatment on wound healing in nicotinized and nonnicotinized rats. The study was conducted on 32 Sprague Dawley rats. The rats were divided into four groups, with eight rats in each: group 1, nonnicotinized rats; group 2, nonnicotinized rats treated with HBO2; group 3, nicotinized rats; and group 4, nicotinized rats treated with HBO2. To prepare the nicotinized groups, the rats were given nicotine for 28 days. At the end of day 28, standard, deep, second-degree to third-degree burns were created on the rats. The HBO2-treated groups underwent HBO2 treatment once a day for 7 days after the creation of the burn damage. All rats were killed 21 days after injury, and the burns were subjected to macroscopic, histopathological, and microbiological evaluation. During this evaluation, the smallest necrotic areas and the lowest rate of fibrosis were observed in group 2. The largest necrotic areas and the highest inflammation and fibrosis rates were observed in the nicotine-treated group 3. When the nicotinized and nonnicotinized groups were compared separately, there was a significant difference in favor of the groups treated with HBO2. Bacterial growth was the highest in the nicotinized group 3, whereas no statistically significant difference was observed among the other groups. We conclude that HBO treatment accelerates the recovery of burn wounds and provides more effective healing by reducing the development of scars both in nicotinized and nonnicotinized rats.

Deep neck infections, which are originated from upper respiratory tract, are bacterial infections involving deep structures of the neck. Unless diagnosed and managed appropriately, these infections may progress rapidly, leading to severe morbidity and mortality. Although, Acinetobacter baumannii plays a significant role in several nosocomial infections, ear nose throat physicians are usually unfamiliar with this bacteria and it is rarely isolated in deep neck infections. In this article, we present a serious case of deep neck infection in which Acinetobacter baumannii was cultured from the abscess. The patient was treated successfully with antibiotic and surgical drainage.

Interferon treatment in hepatitis C virus (HCV) infection is expensive and has various adverse effects. Some markers may help in making decision to stop or maintain the treatment. The aim of this study was to evaluate the effectiveness of serum transforming growth factor beta-1 (TGF-β1) in assessing outcome of interferon treatment in patients with HCV infection. Twelve patients with chronic HCV infections included in the study as treatment group [Treatment group: anti-HCV (+), HCV RNA (+)] and 12 patients with anti-HCV positive, HCV-RNA negative and normal liver function tests included as control group. All patients in the treatment group were administered with peginterferon and ribavirin for 24 weeks. HCV-RNA levels were determined by realtime-PCR and TGF-β1 levels were measured with ELISA methods, at the beginning and 24th week of the treatment. Mann-Whitney U Test and Wilcoxon Test were used to compare variables within and between groups. Median age and male/female ratios were 46 years and 5/7, and 45 years and 3/9 for treatment groups and control group, respectively. Although no difference was found in TGF-β1 levels at the beginning of the treatment between groups (p>0.05), significantly decreased TGF-β1 levels were observed following 24 weeks of interferon treatment in treatment group (p=0.015). Despite limited number of patients, our data suggested that, TGF-β1 levels may be used as a prognostic marker for effectiveness of interferon treatment in patients with hepatitis C virus infection. Key words: Chronic hepatitis C infection, transforming growth factor β1, pegylated interferon, ribavirin, prognostic marker.

BACKGROUND: We evaluated the effects of pneumatic tube system (PTS) transport rates and distances on routine hematology and coagulation analysis. PTS effects on centrifuged blood samples were also examined. METHOD: The study was completed at Dicle University Hospital, which has the longest pneumatic tube system in Turkey. Blood samples were collected at three different locations within the hospital and an emergency department, and delivered to the central laboratory by the PTS or a human carrier. Samples were transported at different rates and over varying distances. Each specimen's potassium (K) and lactic dehydrogenase (LDH) levels, in both the serum and plasma, were tracked to monitor hemolysis. Measurements of LDH and K were obtained using heparin or citrate. RESULT: A positive correlation was observed between distance and hemolysis in serum samples transported at 4.2 m/sec, and at 3.1 m/sec for more than 2200 m (r = 0.774 and r = 0.766, respectively). Distance and hemolysis were also correlated in non‐centrifuged samples (r = 0.871). The alterations in plasma LDH and K levels at different rates and PTS lengths were not statistically significant. CONCLUSION: The rate of hemolysis in PTS transported samples, dependent on PTS length and rate, may seriously affect routine tests of non‐centrifuged samples.

Myiasis cases are often encountered in humans, especially in tropical and subtropical regions. Urogenital myiasis is one of the facultative myiasis cases that may be seen in humans. Psychoda albipennis is an insect species that causes urogential myiasis in humans Adults of this species, belongs to the Psychodidae subfamily, lives especially in humid toilets and domestic bathrooms. This case, presented as urogenital myiasis caused by P. albipennis in a fifteen year old male. The person, who was a student, was living in the city center reported to have passed five-six larvae for three months. The patient had normal urinalysis, stool microscopy and urine culture. Larvae were examined under a microscope and were identified as fourth period larvae of P. albipennis. Therefore, it should not be forgotten that P. albipennis may be an agent in urogenital myiasis.

Nadir rastlanılmasına rağmen varicella zoster virus (VZV) ilişkili pnömoni, virüsün sıklıkla yetişkinleri etkileyen en ciddi komplikasyonudur ve yüksek mortaliteyle seyreder. Bu çalışmada Hepatit B virüs taşıyıcısı 29 yaşında bir erkek hastada VZV pnömonisi tanımlanmaktadır. Hasta beş gündür devam eden halsizlik, boğaz ağrısı, ateş, öksürük ve hafif dispne şikayetleri ile başvurdu. Ayrıca ekzantematöz veziküler döküntüleri vardı. Döküntüler saçlı deriyi de kapsayacak şekilde tüm vücuda yayılmıştı. Fakat hastanın ateşi yoktu ve vital bulgular normaldi. Deri muayenesi ile tüm vücutta papüloveziküllü yaygın polimorfik döküntü ve kabuklu lezyonlar görüldü. Serolojik bulgular, VZV IgM pozitif, VZV IgG pozitif ve HBsAg pozitif idi. Göğüs radyografisinde bilateral pnömonik infiltrasyonlar görüldü. Hastaya valasiklovir ve klaritromisin verildi. Deri lezyonları on gün sonra kayboldu ve hasta tam olarak iyileşti. Sonuç olarak yetişkin hastalarda nadiren oluşan VZV pnömonisinin erken tanısı ve antivirallerle etkin tedavisi ciddi komplikasyonların gelişmesini önleyebilir., Although rarely observed, varicella zoster virus (VZV)-related pneumonia is the most serious complication of the virus, which commonly affects adults and causes high mortality rates. In this study, we describe a case of VZV pneumonia in a 29-year-old male who is an inactive Hepatitis B virus carrier. The patient presented with a 5-day history of fatigue, sore throat, fever, cough and mild dyspnea. He also had an exanthematous vesicular rash. The rash had spread all over his body surface including the hairy skin. But he was not febrile and vital signs were normal. The skin examination exhibited a diffuse polymorphic rash with papules/vesicles, pustules and crusty lesions over the whole body. Serological findings were as follows: VZV IgM positive, VZV IgG positive and HBsAg positive. His chest X-ray showed bilateral pneumonic infiltrations. The patient was prescribed valacyclovir and clarithromycin. The skin lesions disappeared after ten days and the patient made a full recovery. We conclude that an early diagnosis of VZV pneumonia, which rarely occurs in adult patients and its effective treatment with antivirals may prevent the development of serious complications.

Aim: The purpose of this study was to evaluate the long-term data of Neurology Unit and emphasize the importance of hospital infection control. Materials and Method: This study was performed between January, 1997 and December, 2010. The surveillance method was active, prospective, and based on laboratory and patient. Active surveillance of nosocomial infections (NIs) was performed by infection control team, using the criteria proposed by the CDC (The Centers for Disease Control and Prevention) and National Nosocomial Infections Surveillance System (NNIS) methodology. Results: During the study period, 435 episodes were detected in 384 patients. The overall incidence rates (NI/100) and incidence densities (NI/1000 days of stay) of NIs were 3.7% (range 1.0-7.7) and 3.2/1,000 patient-day (range 0.8-7.2/1000), respectively. The most common nosocomial infections by primary site were urinary tract infections (32%), and pneumonia (25.1%). The most prevalent microorganisms were coagulase-negative staphylococci (39.4%), Escherichia coli (18%), Staphylococcus aureus (10%) and Klebsiella spp. (9.9%). Conclusion: We conclude that development of nosocomial infection will be prevented by monitoring the patients in fully-equipped intensive care units, the rapid termination of invasive procedures, appropriate antibiotic therapy and discharging the patient, significantly.

Objectives: The most frequently encountered complication in the transfusion of blood and blood products are transmitted infections from these products. Infections caused by hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) remain the leading most important health problems in the transfusion of blood and blood products worldwide. Therefore, screening tests such as HBsAg, anti-HCV, anti-HIV, and RPR or VDRL for Treponema pallidum are mandatory tests to look at before transfusion of blood and blood products. In this study, the screening tests results of blood donors examined were evaluated and the results were compared with the results of the other blood banks stated in our country. Materials and methods: Screening tests results of a total of 784 blood donors, which have been admitted the Kırıkkale University Hospital Blood Center for blood donation between January 2003 and December 2004, evaluated retrospectively. Blood samples which taken from blood donors before blood donation were investigated for HBsAg, anti-HCV, and anti-HIV tests with chemiluminescense (ELISA) method by automated analyzer. VDRL screening test was investigated by commercial test kit. Results: A total of 734 (93.7%) of 784 blood donors were male and 50 (6.3%) were female. HBsAg was positive in 11 (1.4%) blood donors and anti-HCV in 2 (0.2%) blood donors. None of the blood donors were found to anti-HIV and VDRL seropositivity. Conclusions: Seropositivity rates of HBsAg and anti-HCV were lower than that of Turkey in general. J Clin Exp Invest 2011; 2 (4): 416-419, Amaç: Kan ve kan ürünleri transfüzyonu sonrasında en sık karşılaşılan komplikasyon kullanılan ürünlerden bulaşan enfeksiyonlardır. Kan ve kan ürünleri transfüzyonu sonrasında hepatit B virüsü, hepatit C virüsü ve insan immün yetmezlik virüsünün (HIV) neden olduğu enfeksiyonlar halen en önemli sağlık problemi olmaya devam etmektedir. Bu nedenle; HBsAg, anti-HCV, anti-HIV ve Treponema pallidum\'a yönelik RPR (Rapid Plasma Reagin) veya VDRL (Venereal Disease Research Laboratory) gibi tarama testleri kan transfüzyonlarından hemen önce bakılması zorunlu olan testlerdir. Bu çalışmada, Kan Merkezi\'ne başvuran kan bağışçılarında HBsAg, anti-HCV, anti-HIV ½ ve VDRL testi sonuçları incelenmiş ve sonuçlar ülkemizdeki diğer kan merkezlerinin sonuçları ile karşılaştırılarak değerlendirilmiştir. Gereç ve yöntem: Ocak 2003-Aralık 2004 tarihleri arasında Kırıkkale Üniversitesi Hastanesi Kan Merkezine başvuran toplam 784 kan bağışçısının tarama testi sonuçları retrospektif olarak incelendi. Kan bağışçılarından alınan kan örnekleri Enfeksiyon Hastalıkları laboratuvarında otomatize analiz cihazı kullanılarak kemiluminesans (ELISA) yöntemi ile çalışıldı. VDRL testi ise ticari test kiti kullanılarak yapıldı. Bulgular: Toplam 784 kan bağışçısının 734\'ünün (%93.7) cinsiyeti erkek, 50\'sinin (%5.4) cinsiyeti ise kadındı. 11\'inde (%1.4) HBsAg ve 2\'sinde (%0.2) anti-HCV pozitif olarak saptandı. Anti-HIV ve VDRL pozitifliği ise saptanmadı. Sonuçlar: Bulgularımız HBsAg ve anti-HCV seropozitiflik oranlarının Türkiye geneline göre daha düşük olduğunu göstermektedir.

Pertussis (whooping cough), caused by Bordetella pertussis is a severe, acute contagious disease of the respiratory system and it affects mostly children and also susceptible individuals of all ages. Although the conventional culture method used for diagnosis is highly specific, it has a lower sensitivity. Therefore, there is a need for a sensitive, specific and rapid method for diagnosis of pertussis. Polymerase chain reaction (PCR), introduced recently as a new approach for diagnosis of pertussis, has been shown to be more sensitive than culture method. Pertussis toxin gene (ptxA-Pr), insertion sequence genes (IS481 and IS1001), adenylate cyclase genes and structural porin and flagellin genes were chosen as targets for PCR, in different studies. This study aimed to develop and optimize a diagnostic inhouse PCR method by using primers specific for ptxA-Pr and IS481 gene regions. An in-house PCR method was developed by using primer pairs of PTp1/PTp2 specific for ptxA-Pr gene and PIp1/PIp2 specific for IS481 gene and DNAs of various bacterial reference strains. Throat samples obtained from 45 healthy individuals and B.pertussis reference strain with decreasing concentrations were mixed to constitute a group of "representative clinical samples" and used to test and optimize sensitivity and specificity of the method. The in-house PCR with PTp1/PTp2 primers showed a very high specificity but a low sensitivity with a value of 34.4 cfu/Rm (colony forming unit/reaction mixture). Whereas, the inhouse PCR with PIp1/PIp2 primers exhibited a low specificity due to cross-reactivity with B. Pertussis and B.bronchiseptica but much higher sensitivity with a value of 1.12 cfu/Rm. The experiments performed with the representative clinical samples yielded similar results. Simultaneously applied cultivation studies indicated the detection limit of the PCR method as 2 x 103 cfu/ml. Based on our results, the PCR targeting IS481 gene had high sensitivity while the PCR targeting ptxA-Pr gene had high specificity. It was concluded that, PCR method targeting the IS481 gene might be used for pre-diagnosis and then PCR for ptxA-Pr gene might be applied for the confirmation of B.pertussis in the molecular diagnosis of pertussis.

Amac: Insan bagisik yetmezlik virusu (HIV), Hepatit B ve Hepatit C virusleri ile Treponema pallidum, parenteral ve cinsel yolla bulasan enfeksiyon etkenleridir. Ulkemizde evlenecek ciftlere yasal prosedur ve ilgili mevzuat kapsaminda evlilik oncesi tarama testi yapilarak, basvuranlarin cinsel yolla bulasan hastaliklar yonunden tetkikleri degerlendirilmektedir. Bu calismanin amaci; evlilik oncesi tarama amacli yapilan HBsAg, anti-HCV, anti-HIV I/II ve Treponema pallidum antikorlari (anti-Treponema pallidum IgG, IgA ve IgM) test sonuclarinin degerlendirilmesidir. Gerec ve yontem: Kiziltepe Devlet Hastanesi Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Poliklinigine Ocak 2011-Mart 2011 tarihleri arasinda evlilik oncesi tarama testi yaptirmak icin gelen 117 hasta randomize olarak calismaya dahil edildi. Bu hastalarin 64'u bayan (yas ortalamasi 24.7±5.7), 55'i erkekti (yas ortalamasi 24.7±4.7). Hastalarin HBsAg, anti-HCV ve anti-HIV I/II testleri makro-ELISA cihazinda (Vitros ECIQ, Ortho Clinical Diagnostics, USA), anti-Treponema pallidum IgG, IgA ve IgM antikorlarinin taranmasi ise immunokromatografik hizli testle (Syphilis Syphilis 3.0, Standard Diagnostic, Inc. Korea) calisildi. Bulgular: Calismaya alinan 119 hastanin 5'inde (%4.2) HBsAg pozitifligi belirlendi. Bu 5 hastanin 3'u erkek ve 2'si bayandi. Anti-HCV, anti-HIV I/II ve anti-Treponema pallidum IgG, IgA ve IgM antikor testleri ise butun hastalarda negatif olarak bulundu. Sonuc: Calismada elde edilen HBsAg test sonucunun, bolgemizdeki HBsAg pozitiflik orani ile uyumlu oldugu bulundu. Sonuc olarak evlilik oncesi yapilan tarama testlerinin cinsel yolla bulasan hastaliklarin onlenmesindeki oneminin artarak devam edecegi kanaatindeyiz.

Objectives: Intestinal parasitosis is a major public health problem particularly in the developing countries and affects approximately 4 billion people globally. The presented study aimed to determine the prevalence of multiple (mixt) intestinal parasites and potential source of infection in our region. Materials and methods: A total of 1,620 stool specimen that sent to Kızıltepe State Hospital Microbiology Laboratory throughout a 4 months period to investigate for parasitic agents were included. Following macroscopic examination, stool specimens were precipitated and examined for intestinal parasites by copro-parasitological methods including native-lugol method. All of stool specimens were investigated for Entamoeba histolytica/dispar screening by Micro-ELISA method using commercial kits regarding with the existence of adhesin antigens. Results: In this study, a total of 1,620 human stool samples were examined and 447 (27.6%) were found to be favorable for intestinal parasites. Among infected stool samples, 63 (14.1%) were infected with two parasites and 18 (4.0%) with three parasites. The first three most common parasites were Giardia intestinalis (43.3%), Taenia spp. (36.4%) and Trichomonas hominis (5.4%). There was no significant difference between males and females in multiple infected (G. intestinalis & Taenia spp.) stool samples (p>0.05). Conclusion: Our findings suggested that intestinal parasitic infections remain endemic in our region., Amaç: İntestinal parazitler, özellikle gelişmekte olan ülkeler başta olmak üzere küresel olarak yaklaşık dört milyar insanı etkileyen önemli bir halk sağlığı sorunudur. Bu çalışma; çoklu (mikst) intestinal parazit prevalansını ve potansiyel infeksiyon kaynağını belirlemek amacıyla yapılmıştır. Gereç ve yöntem: Çalışmaya 4 aylık periyotta, Kızıltepe Devlet Hastanesi Mikrobiyoloji Laboratuvarına paraziter etken varlığının araştırılması amacıyla gönderilen 1620 dışkı örneği prospektif olarak dahil edildi. Makroskobik inceleme sonrası dışkı örnekleri, dışkı konsantratör tüpü ile çöktürülüp kopro-parazitolojik yöntemlerden nativ-lugol yöntemi uygulanarak intestinal parazitler yönünden incelendi. Dışkı örneklerinin tamamı Entamoeba histolytica/dispar taraması için ticari test kiti kullanılarak Mikro-ELISA yöntemi ile adhezin antijen varlığı yönünden araştırıldı. Bulgular: Çalışmada, toplam 1620 insan dışkı örneği incelendi ve 447\'si (% 27.6) intestinal parazitler yönünden olumlu bulundu. Enfekte dışkı örnekleri arasında; 63\'ünün (% 14.1) iki parazit ve 18\'inin (% 4.0) üç parazit ile çoklu infekte olduğu görüldü. Giardia intestinalis (% 43.3), Taenia spp. (% 36.4) ve Trichomonas hominis (% 5.4) en sık tespit edilen parazitlerdi. Çoklu parazitle (G. intestinalis & Taenia spp.) infekte dışkı örneklerinde kadın ve erkekler arasında cinsiyet açısından istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Sonuç: Bulgularımız bölgemizde parazitik infeksiyonların endemik kalmaya devam ettiğini göstermektedir.

Objectives: Extended spectrum beta-lactamases (ESBL), are enzymes which can hydrolise cephalosporins and monobactams and usually responsible for resistance to beta-lactam antibiotics in Gram negative bacilli. The presence of ESBL in Escherichia coli strains isolated from urine samples in a State Hospital, was investigated and the sensitivity of these strains to some antibiotics was examined.Materials and methods: E. coli strains isolated from urinary cultures were identified by conventional methods. Antimicrobial susceptibility tests have been studied by using “Kirby-Bauer disk diffusion method”. Extended Spectrum β-Lactamase producing E. coli strains have been detected by using “double disk synergy test”.Results: In this study, the prevalence of ESBL producing isolates among E. coli was found to be 13%. The antimicrobial resistance rates of ESBL positive strains to many antibiotics which were not substrate for these enzymes were found higher than those of ESBL negative strains (p

Amac: Calismamizda, son iki yil icerisinde Mardin Kadin Dogum ve Cocuk Hastaliklari Hastanesi\'ne basvuran risk grubu kadinlarda konjenital enfeksiyonlara neden olabilen Toxoplasma gondii ve Rubella virus\'une karsi olusan antikorlarin seroprevalansi arastirildi. Yontem: Mayis 2008-Nisan 2010 tarihleri arasinda hastanemize basvuran, risk grubunu olusturan dogurganlik cagindaki kadinlardan alinan serum ornekleri Toxoplasma gondii ve Rubella virus\'une karsi olusan antikorlar yonunden test edildi. Anti-Toksoplazma IgM ve IgG ile anti-Rubella IgM ve IgG antikorlari kemiluminesans yontemi ile otoimmunanalizorde (Advia Centaur, Siemens) uretici firmanin onerileri dogrultusunda calisildi. Bulgular: Toplam olarak test edilen 3.474 serum orneginde, Toxoplasma gondii icin IgM ve IgG seroprevalansi sirasiyla; %4.6 ve %17.5 olarak bulundu. Rubella virus icin test edilen 3.460 serum orneginde IgM ve IgG seroprevalansi ise sirasiyla; %0.95 ve %76.5 idi. Sonuc: Genis populasyon taramalari, Toxoplasma gondii ve Rubella virus\'une bagli konjenital enfeksiyonlarin onlenmesine katki saglayabilir. Dogurganlik cagindaki kadinlarda Toxoplasma gondii ve Rubella virus icin yuksek seropozitivite bulundugundan koruyucu tedbirler alinmalidir

Objectives: Infectious gastroenteritis is one of most important causes of morbidity and mortality in children. Rotavirus and enteric adenoviruses are the most important agents of infectious gastroenteritis. Little is known about the epidemiology of rotavirus and enteric adenovirus gastroenteritis in our region. This study was aimed to determine the frequency of rotavirus and enteric adenovirus gastroenteritis in pediatric patients admitted to our hospital. Materials and Methods: Fresh stool specimens of total 941 pediatric patients admitted to our hospital during October 2008 and September 2009 due to acute gastroenteritis were studied. Rotavirus and enteric adenovirus antigens were investigated in the fresh stool specimens with the qualitative immunochromatographic test. Results: In 170 (18.1%) of fresh stool specimens, viral antigens were determined. Of these 170 specimens, rotavirus was established in 157 (16.7%), enteric adenovirus in 9 (1.0%), both rotavirus and enteric adenovirus in 4 (0.4%). The viral antigen positive cases were most frequently seen during autumn and winter months in children between 5-24 months of age. Conclusion: Rotavirus is most important agent in acute gastroenteritis of childhood in our region too. It should be investigated routinely in fresh stool specimens, especially in the autumn and winter months.

Objective To detect the subtype characterization and drug-resistant mutations in HIV-1 strains after the refugee movement from Syria to Turkey between 2011 and 2014 in south east border lines. Methods A total of 65 patients were included in this study, of which 57 (88%) patients were antiretroviral therapy-naive patients. HIV-1 RNA was detected and quantified by real-time PCR assay. HIV-1 subtypes and circulating recombinant forms (CRFs) were identified by phylogenetic analysis (neighbor-joining method), and drug-resistant mutations were analyzed. Results Three major HIV groups were indicated. Two of these groups were located in subtype B. The other group showed heterogeneity. Subtype B (48/65, 73.8%), followed by CRFs (12/65, 18.5%) was the most common strain. Subtype of CRFs consisted of CRF01_AE (9/65, 13.8%) and CRF02_AG (3/65, 4.6%). Subtype C (1/65, 1.5%), sub-subtypes A1 (2/65, 3.1%) and F1 (2/65, 3.1%) were also detected with low prevalence. The rate of overall primary antiretroviral resistance was 4.9% (3/61). Drug-resistant rate for non-nucleoside reverse transcriptase inhibitors was 4.9%. The thymidine analogue mutation rate was 13.1% (8/61). Conclusions HIV molecular epidemiology studies are necessary to determine transmission patterns and spread. Subtype B and CRF01_AE, CRF02_AG are the most prevalent strains in the south-east of Turkey. However, subtype C, sub-subtypes A1 and F1 are of low prevalence but persist in the south-east of Turkey. In the near future, changing of HIV epidemiology will be possible in Turkey due to migration movement in border lines and resistance testing will play an important role in HIV management.