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Objective: COVID-19 has been detected in Turkey since March 11, 2020. Istanbul has become an important center of the pandemic in Turkey. Various risk factors for COVID-19 infection, mortality, and morbidity are under investigation. Recent studies have suggested that certain blood groups are risk factors for the disease. The aim of this study is the evaluation the relationship between blood groups and the risk of contracting COVID-19 disease, clinical severity of the disease, and CT (computed tomography) imaging findings. Material and Methods: Age, gender, blood group data, clinical severity and CT images of 300 patients who were positive with RT PCR (Reverse transcription-polymerase chain reaction) and were followed up in the clinic were retrospectively scanned and recorded. The clinical severity of the disease and CT imaging findings were scored, and the data were evaluated statistically. Results: While the incidence of COVID-19 was high in the A blood group, it was low in the 0 blood group. Although there was no significant difference between blood types and clinical severity, the involvement in the B blood group was more severe on CT imaging. Conclusion: People with A blood group should pay more attention to protection and isolation. Investigating this difference and underlying pathogenic mechanisms can guide science with advanced studies.

SUMMARY OBJECTIVE: The objectives of this study were to describe lung computed tomography findings of patients with COVID-19 diagnosed by real-time reverse transcription polymerase chain reaction test, investigate whether the findings differ regarding age and gender, and evaluate the diagnostic performance of chest computed tomography based on the duration of symptoms at the time of presentation to the hospital. METHODS: From March 11 to May 11, 2020, 1271 consecutive patients (733 males and 538 females) were included in this retrospective, cross-sectional study. Based on age, patients were divided into five separate subgroups. Then based on the duration of symptoms, patients were divided into five separate phases. The presence of lung lesion(s) and their characteristics, distribution patterns, and the presence of concomitant pleural thickening/effusion and other findings (malignancy, metastasis, chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, bronchiectasis, cardiomegaly, pericardial effusion) were evaluated by five radiologists independently. RESULTS: The “normal lung computed tomography finding” was the most common chest CT finding (37%), followed by ground-glass opacity (31%). Regardless of the shape of the lesion, the distribution features were significant (peripheral, subpleural, and lower lobe distribution) (p

OBJECTIVE: Turkey is one of the latest countries that COVID-19 disease was reported, with the first case on March 11, 2020, and since then, Istanbul became the epicenter of the pandemic in Turkey. Here, we reveal sequences of the virus isolated from three different patients with various clinical presentations. METHODS: Nasopharyngeal swab specimens of the patients were tested positive for the COVID-19 by qRT-PCR. Viral RNA extraction was performed from the same swab samples. Amplicon based libraries were prepared and sequenced using the Illumina NextSeq platform. Raw sequencing data were processed for variant calling and generating near-complete genome sequences. All three genomes were evaluated and compared with other worldwide isolates. RESULTS: The patients showed various clinics (an asymptomatic patient, patient with mild disease, and with severe pulmonary infiltration). Amplicon-based next-generation sequencing approach successfully applied to generate near-complete genomes with an average depth of 2.616. All three viral genomes carried the D614G variant (G clade according to GISAID classification) with implications for the origin of a spread first through China to Europe then to Istanbul. CONCLUSION: Here, we report the viral genomes circulating in Istanbul for the first time. Further sequencing of the virus isolates may enable us to understand variations in disease presentation and association with viral factors if there is any. In addition, the sequencing of more viral genomes will delineate the spread of disease and will guide and ease the necessary measures taken to stem the spread of the novel coronavirus.

The aim of our study is to determine the risk of coinfection with COVID-19 due to the high prevalence of viral agents in Istanbul in autumn (September, October, and November) and winter (December and January) and to investigate the effects of age, gender, season and clinical features on the development of coinfection with COVID-19.In the routine studies of our hospital, COVID-19, reverse transcriptase polymerase chain reaction (RTA kit, Turkiye) and Multiplex PCR Bio-Fire (Bio Merieux Company, France) methods were studied from the nasopharyngeal swab sample and the data were recorded. A total of 400 people with a mean age (7.91±17.80) were included in the study by retrospective scanning.Considering the virus distribution, Respiratory syncytial virus (RSV), COVID-19, rhino/entero virus did not show a significant difference in autumn and winter, while H. metapneumovirus, adeno virus, influenza A significantly higher rates were observed in winter months. Parainfluenza (1, 2, 3, 4) and Corona OC43 were detected at a higher rate in autumn compared to other viruses. Double and triple coinfection rates with other viral agents were high for 2 years and younger.The risk of coinfection of COVID-19 with influenza A, RSV, parainfluenza, and rhino/entero virus was found to be higher than other viral agents. Especially in winter, the risk of coinfection with influenza A and COVID-19 increases. In terms of treatment management, coinfection should be investigated in risky patients and influenza a vaccine should be offered to risky groups.

SummaryCOVID-19 is a viral respiratory disease caused by SARS-CoV-2 infection. Global efforts of genomic surveillance of the virus give chance to track the spread of the pandemic. Global emergence of some viral mutations called attention and various studies have been suggested about increased infectivity of the virus. Herein, we sequenced viral genomes isolated from 184 patients in Istanbul and analyzed clinical metadata for the investigation of any viral mutation which affects the disease course of the host. We did not detect any viral mutations affecting the disease outcome in our cohort. Besides, we observed intra-host mutations in 76% of the isolates. Insertion/deletion and stop-gain mutations are also significantly less common among intra-host variants compared to consensus viral genome mutations. Longitudinal genomic surveillance is essential for timely detection of any lineages that might affect clinical outcome, the performance of diagnostic assays, or even the immunological escape of the virus.

SUMMARYCOVID-19 is a global threat with an increasing number of infections. Research on IgG seroprevalence among health care workers (HCWs) is needed to re-evaluate health policies. This study was performed in three pandemic hospitals in Istanbul and Kocaeli. Different clusters of HCWs were screened for SARS-CoV-2 infection. Seropositivity rate among participants was evaluated by chemiluminescent microparticle immunoassay. We recruited 813 non-infected and 119 PCR-confirmed infected HCWs. Of the previously undiagnosed HCWs, 22 (2.7%) were seropositive. Seropositivity rates were highest for cleaning staff (6%), physicians (4%), nurses (2.2%) and radiology technicians (1%). Non-pandemic clinic (6.4%) and ICU (4.3%) had the highest prevalence. HCWs in “high risk group” had similar seropositivity rate with “no risk” group (2.9 vs 3.6p=0.7), indicating the efficient implementation of protection measures in the hospitals in Turkey. These findings might lead to the re-evaluation of infection control and transmission dynamics in hospitals.

The gold standard method in the diagnosis of SARS-CoV-2 infection is the detection of viral RNA in nasopharyngeal sample by RT-PCR. Recently, saliva samples has been suggested as an alternative due to being fast, reliable and non-invasive, rather than nasopharyngeal samples. We compared RT-PCR results in nasopharyngeal, oro-nasopharyngeal and saliva samples of COVID-19 patients. 98 of 200 patients were positive in RT-PCR analysis performed before the hospitalization. In day 0, at least one sample was positive in 67% of 98 patients. Positivity rate was 83% for both oro-nasopharyngeal and nasopharyngeal samples, while it was 63% for saliva samples (p

BackgroundThe new type of Coronavirus infection had become a pandemic in a very short period since it was first seen in Wuhan. The outbreak had a negative impact on all health care systems throughout the world and overwhelmed the diagnostic laboratories as well. During the pandemic, handling patient specimens in accordance with the universal guidelines was troublesome as WHO, CDC and ECDC required cold chain compliance during transporting and storing the swap samples.Materials and methodsIn this study, we tested diagnostic performance of RT-PCR on 30 swab samples stored at ambient temperature and compared them with the samples stored at +4°C.ResultsOur results revealed that all the samples stored at ambient temperature remain PCR positive for at least five days. We did not see any false negativity.ConclusionIn conclusion, we report that transferring and storing of nasopharyngeal/oropharyngeal samples at ambient temperature could be possible in the resource-limited conditions like pandemic.

The WHO-named Coronavirus Disease 2019 (COVID-19) infection had become a pandemic within a short time period since it was detected in Wuhan. The outbreak required the screening of millions of samples daily and overwhelmed diagnostic laboratories worldwide. During this pandemic, the handling of patient specimens according to the universal guidelines was extremely difficult as the WHO, CDC and ECDC required cold chain compliance during transport and storage of the swab samples. The aim of this study was to compare the effects of two different storage conditions on the COVID-19 real-time PCR assay on 30 positive nasopharyngeal and/or oropharyngeal samples stored at both ambient temperature (22 ± 2 °C) and +4 °C. The results revealed that all the samples stored at ambient temperature remain PCR positive for at least six days without any false-negative result. In conclusion, transporting and storing these types of swab samples at ambient temperature for six days under resource-limited conditions during the COVID-19 pandemics are acceptable.

The aim of the study is to determine in-vitro effects of imipenem-tigecycline, imipenem-colistin and tigecycline-colistin against carbapenem-resistant Enterobacteriaceae (CRE) isolates. A total of 25 CRE isolates were included to the study. The minimum inhibition concentrations of imipenem, colistin-sulphate and tigecycline were determined with broth dilution method. Synergistic effects of imipenem-tigecycline, imipenem-colistin and tigecycline-colistin were investigated by microdilution checkerboard technique. All of the isolates were resistant to imipenem, whereas 25% of the isolates were resistant to colistin and tigecycline. Imipenem-colistin, imipenem-tigecycline and tigecycline-colistin combinations were synergistic against 40% (10/25), 24% (6/25), and 36% (9/25) of the isolates, respectively. Antagonism was observed in 8% (2/25) of the isolates in tigecycline-colistin combination. Tigecycline-colistin was the most effective (70% synergy) combination in Klebsiella spp. strains; whereas imipenem-colistin was the most effective (75% synergy) combination in Escherichia coli strains. Synergistic effect was variable and strain-depended against CRE isolates that have been tested.

NCI-2020-0130

Highlights • SARS-CoV-2 detection from saliva was more consistent during extended hospitalization and recovery. • Testing saliva samples before the end of isolation in individuals under treatment can be effective in spreading Covid-19. • Taking saliva samples along with the standard method before ending the isolation in individuals treated with hydroxychloroquine can be effective in minimizing contamination in the community by reducing the false negativity rate., The gold standard method in the diagnosis of SARS-CoV-2 infection is the detection of viral RNA in the nasopharyngeal sample by RT-PCR. Recently, saliva samples have been suggested as an alternative sample. In the present study, we aimed to compare RT-PCR results in nasopharyngeal, oro-nasopharyngeal and saliva samples of COVID-19 patients. 98 of 200 patients were positive in RT-PCR analysis performed before the hospitalization. On day 0, at least one sample was positive in 67 % of 98 patients. The positivity rate was 83 % for both oro-nasopharyngeal and nasopharyngeal samples, while it was 63 % for saliva samples (p

Alpay, Yeşim (Balikesir Author), Objective: Sleeves, rings, bracelets etc. are the surfaces that mostly get soiled and exposed to bacterial contamination while working at clinics, laboratories or contacting with patients. Since sleeves of white coats can be a suitable growth medium, we assessed and interpreted cultures which were taken from surfaces of sleeves. Methods: Samples were taken from contact surface sides of sleeves (considering right-left handedness) by sterile saline moisturized swabs. Samples were inoculated to eosin-methylene blue and blood agars. Samples with different colony morphologies were assessed with Gram staining after 24-hour incubation. Gram-positive cocci which were further tested for catalase and coagulase (tube and slide) reactions inoculated to Mueller-Hinton medium after being adjusted to 0.5 McFarland turbidity standard. Methicillin resistance tested by using cefoxitin disk. Antibiotic susceptibilities were investigated by disk diffusion method according to the recommendations of Clinical and Laboratory Standards Institute. Results: We assessed 80 samples and detected 4 types of colonies in 2 samples, 3 types of colonies in 9 samples, 2 types of colonies in 13 samples and 1 type of colony in 43 samples. There was no bacterial growth in 13 samples obtained after recent wash. Bacterial growths were 42 methicillin-sensitive coagulase-negative staphylococci (CNS), 8 methicillin-sensitive Staphylococcus aureus, 16 methicillin-resistant CNS, 7 micrococci, 10 diphtheroids, 7 Bacillus spp., 1 alpha-hemolytic streptococci, 2 Gram-negative bacilli and 5 yeasts., Amaç: Giysi kolları ve bilezik, yüzük gibi takılar, klinikte ve laboratuvarlarda çalışırken ve hastayla temas esnasında, çok kirlenen ve bakteri kontaminasyonu açısından uygun zemin oluşturan alanlardır. Beyaz önlüklerin uzun kollarında da benzer şekilde kontaminasyon olacağından yola çıkılarak, önlük kollarından alınan kültürlerin değerlendirilmesi amaçlanmıştır. Yöntemler: Steril serum fizyolojikle nemlendirilen eküvyonla önlük kollarının (sağ ve sol el kullanımına göre), yüzeylerle temas eden alt kısımlarına sürülerek örnek alınmıştır. Alınan örnekler eozin-metilen mavisi agarına ve kanlı agara ekilerek 37°C’de 24 saat inkübe edilmiştir. Kültür plaklarında üreyen koloniler Gram boyamasıyla değerlendirilmiştir. Gram-pozitif koklara katalaz, koagülaz (tüp ve lam koagülaz) testleri yapılmıştır. Stafilokok olarak değerlendirilen koloniler, bulanıklığı 0.5 McFarland standardına ayarlanarak süspansiyon haline getirildikten sonra Mueller-Hinton besiyerine ekilmiştir. Metisilin direnci sefoksitin diskiyle araştırılmıştır. Antibiyotik duyarlılık testi Clinical and Laboratory Standards Institute önerilerine göre disk difüzyon yöntemiyle yapılmıştır. Bulgular: Değerlendirilen toplam 80 örneğin 2’sinde farklı 4 tip, 9’unda farklı 3 tip, 13’ünde farklı 2 tip üreme, 43 örnekte ise tek tip üreme olmuştur. Yıkama sonrası 1-3. günlerde alınan 13 örnekte üreme olmamıştır. Üremelerin 42’si metisiline duyarlı koagülaz-negatif stafilokoklar, 8’i metisiline duyarlı Staphylococcus aureus, 16’sı metisiline dirençli koagülaz-negatif stafilokoklar, 7’si mikrokoklar, 10’u difteroidler, 7’si Bacillus spp., 1’i α-hemolitik streptokoklar, 2’si Gram-negatif basiller ve 5’i maya olarak tespit edilmiştir. Sonuçlar: Önlük kollarının çalışma alanlarıyla temas halinde olması mikroorganizma kolonizasyonu için uygun ortam hazırlamaktadır. Örneklerin %84’ünde üreme olması ve %30’unda birden fazla mikroorganizma saptanması bunu desteklemektedir. Kısa kollu önlük tercih edilmesi, el yıkamanın bilekleri de kapsayacak şekilde yapılmasını ve hastane infeksiyonlarının daha etkin bir biçimde önlenmesini sağlayabilir

Objective: The most important problem in the treatment of nosocomial Acinetobacter baumannii (A. baumannii) infections which is increasingly seen in recent years is that almost all strains are resistant to many antibiotics, including carbapenems, and that the extinction of antibiotic options to be used in treatment. This leads the clinicians to new treatment options and suggests the use of combined antibiotics to achieve success in both the treatment of multi-drug-resistant A. baumannii (MDRAB) infections as well as to prevent resistance development. We investigated the in vitro activity of colistin in combination with vancomycin, linezolid or daptomycin against MDRAB to determine whether these combinations would be considered for clinical use. . Methods: The fractional inhibitory concentration (FIC) index was used to determine the antibiotic combination effects and to evaluate the effect of antibiotic combinations on the bacteria. Results: MIC values of colistin/vancomycin, colistin/linezolid, and colistin/daptomycin in 10 strains (33.3%) gave similar results. Twenty strains gave different MIC results according to antibiotics. The colistin/daptomycin antagonistic ratio was high when the colistin/vancomycin synergy ratio was high compared to the others. Conclusion: Antibiotic combinations can be used as an alternative treatment approach in multi-drug resistant A. baumannii infections.

DOI:10.5505/bsbd.2015.87587 OZET AMAC: Ellerin ve elle temas eden yuzeylerin mikroorganizma ile kolonizasyonu hastane enfeksiyonlari gelisiminde onemli yer tutmaktadir. Gunumuzde cep telefonlari saglik calisanlarinin gunluk en cok temas ettikleri gerecler arasinda yer almaktadir. Calismamizda dokunmatik ekranli cep telefonlarinin yuzeyinden alinan kulturler ile mikroorganizma kolonizasyonu ve ureyen patojenlerin turu belirlenerek, onemi ve hastane enfeksiyonu gelisiminde rol alip alamayacagi degerlendirildi. YONTEM ve GERECLER: Cep telefonlarinin yuzeyinden ekuvyonla ornek alinarak kanli ve EMB (eosin methylene blue) besiyerine ekim yapildi. 24 saat sonra koloni morfolojisi farkli olanlar gram boyama ile degerlendirildi. Gram pozitif koklara katalaz, koagulaz (tup ve lam koagulaz bakildi) yapildi. Mueller hinton besiyerine 0.5 macfarland ayarlanarak ekildi. FOX (sefoksitin) diski konuldu. Direncli ve duyarli bakteriler CLSI Kriterlerine gore degerlendiridi. BULGULAR: Alinan 45 ornekten 8 (%17.7)’inde ureme olmadi. Ureme gozlenen 37 (%82.3) ornegin 5’inde 3 farkli tip, 15’inde 2 farkli tip, 17’sinde ise tek tip ureme oldu. Identifikasyon sonrasi; 32 (%51.6) MSKNS (metisilin duyarli koagulaz negatif stafilokok), 13 (%20,9) MSSA (metisilin duyarli staphylococcus aureus, 5 (%8.06) MRKNS (metisilin direncli koagulaz negatif staphylococcus), 7 (%11.2) mikrokok,4 (% 6.4) bacillus spp ve 1 (% 1.6) AHS (alfa hemolitik streptokok) uredigi tespit edildi. TARTISMA ve SONUC: Elle temas sikligi nedeniyle cep telefonu yuzeyleri mikroorganizma kolonizasyonu icin uygun ortamlar olup hasta ile temas oncesi ve sonrasinda el hijyenine uyulmamasi, hasta, saglik calisani ve cep telefonu gibi cansiz yuzeyler arasinda mikrorganizma transferine neden olabilmektedir. Bu zincirin kirilmasi acisindan hastane enfeksiyonlarindan korunmada en temel yontem olan el yikama onerilmekte olup, dezenfektan mendil ile cep telefonu temizligi ikincil bir secenek olabilir. Nitekim karsilastirma icin yeterli sayida orneklem olmasa da ureme olmayan ve tek uremelerin oldugu cep telefonlarinin laboratuvar calisanlarina ait olmasi eldiven kullaniminin ve sik el yikamanin bu dongudeki katkisini dusundurmus olup daha kapsamli gruplarda calisilmasi fikrini dogurmustur. Anahtar Kelimeler: Saglik Calisanlari, Cep Telefonu, Mikroorganizma kolonizasyonu

It is important to follow up the epidemiologic and clinical characteristics of the viral especially rotavirus gastroenteritis to develop strategies for prevention and treatment. Therefore we investigated the rotavirus gastroenteritis in acute diarrhea patinets in our clinic. Stool samples of 263 patients admitted to outpatient clinic or emergency room of COMU Faculty of Medicine Hospital with the symptom of acute diarrhea were screened retrospectively from medical records. Stool samples had been studied with the monoclonal antibody based chromatographic immunoassay (Rota-Adeno Virus Combo Test Device, Ecotest, China). 263 medical records were screened. Rotavirus antigen was positive in 62 cases (23.6%). It was 34.5% in children under 2 years. Rota positivity according to the seasons was as follows: 27.8% in spring, 14.6% in summer, 26.3% in autumn and 21.4% in winter. As a result, acute diarrhea case management should be done for age and seasonal distribution. In these cases unnecessary antibiotic usage should be avoided by rapid diagnostic test when required.

Diagnosis of brucellosis basically depends on blood and/or bone marrow culture and demonstration of high titer specific antibody or seroconversion in serum. In routine serological diagnosis of the disease, after screening with Rose Bengal test, the positive samples are studied with standart tube agglutination (STA) test with serial dilutions. However false negative results can be seen in STA test due to the existence of blocking antibodies, this test should be verified with Coombs anti-Brucella (CAB) or immunocapture agglutination (ICA) tests. In recent years Brucella Coombs gel test (ODAK Brucella Coombs Gel Test, Toprak Medikal, Turkey) developed in our country, was available as a new and rapid agglutination based method. The test is performed in vials that contain Coombs antibodies within gel matrix and results are evaluated visually within two hours.The aim of this study was to compare the efficacy of Brucella Coombs gel test (BCGT) with STA, CAB and ICA methods in serological diagnosis of brucellosis. A total of 100 serum samples with suspected brucellosis sent to our laboratory between January 2012-August 2013 in which 31 high positive (≥ 1/160), 23 low positive (≤ 1/80) and 46 negative samples diagnosed with CAB test (Seromed, Turkey) were included in the study. All the samples were studied using titrations with STA (Seromed, Turkey), ICA (Vircell, Spain) and BCGT (Islab, Turkey) methods. With STA, CAB and BCGT tests ≥ 1/160, with ICA test ≥ 1/320 were accepted as positive titers. The correlation between the tests were evaluated with Cohen's kappa (κ) analysis. In our study, seven of the samples yielded positive results with STA, 30 with ICA, and 32 with BCGT. The number of the sera which yielded positive results with all three methods was 28. Two samples positive with CAB and BCGT resulted low titer/negative with ICA, one sample positive with ICA and BCGT resulted low titer/negative with CAB, and one low titer/negative sample with CAB and BCGT yielded positive with ICA test. STA test was not included in the statistical evaluation due to its very low positivity rate. According to the kappa analysis, almost perfect agreement was detected between the other methods (κ= 0.887 for CAB and ICA, κ= 0.977 for CAB and BCGT, κ= 0.907 for ICA and BCGT). In conclusion, BCGT method showed excellent correlation with both CAB and ICA tests; the application of the test was practical; resulted in a short time such as two hours and visually evaluation was determined to be practical compared to other methods. Although BCGT can be recommended for routine diagnostics, evaluation of specificity and sensitivity with comprehensive studies including a greater number of cases and control samples should be considered.

Nocardiosis is a rare disease generally caused by members of Nocardia asteroides complex, particularly in immunosupressed patients. Nocardia cyriacigeorgica is a newly described member of this complex. In this article, a case of pulmonary nocardiosis with a large solitary cavitary nodule caused by N. cyriacigeorgica, in a patient receiving corticosteroid therapy was presented. A 29 years old male patient receiving prednisolone for 5 months was admitted to our hospital with fever, cough, right thoracic pain and night sweats. Computed tomography scan of chest demonstrated a large solitary cavitary nodule in the right lower lobe. Gram stained smear of the sputum revealed gram-positive, beaded, branched filamentous bacilli. On the third day of his admission, a catalase positive, oxidase negative and immotile bacilli, compatible with Nocardia spp., were isolated from the sputum sample taken at the day of admission. The isolated bacterium was identified as N. cyriacigeorgica by reference laboratory (Lyon, France). Oral trimethoprim (320 mg/day) and sulfamethoxazole (1600 mg/day) therapy given for three months, resulted in complete cure of the lesion without any sequela. This was the fourth case of pulmonary nocardiosis caused by N. cyriacigeorgica reported from Turkey. Microbiological examination of sputum is the most important tool for the diagnosis. Treatment with appropriate antibiotics may achieve complete cure even in large cavitary lesions. In conclusion, pulmonary nocardiosis should be considered in differential diagnosis of solitary cavitary nodules, especially in immunocompromised patients.

Sporotrichosis is a cutaneous or systemic fungal infection caused by Sporothrix schenckii. The infection is characterized by nodular, pustular, or ulcerative lesions. Infection usually occurs after traumatic implantation of the fungus into the skin. We report a case presenting first cellulitis and later on as a non-healing ulcer which was diagnosed by punch biopsy as sporotrichosis and managed successfully with itraconazole. A 56-year-old woman admitted to our department with complaint acute onset of swelling of the right lower-extremity with erythema and warmth. The patient was diagnosed initially as celulitis and started on ampicillin-sulbactam. Diagnosis of sporotrichosis was made with histological examination skin biopsy and the patient was started on itraconazole. One month after commencement of antifungal treatment, the ulcer began to dry up and at 3 months the lesions had healed. This case shows that if a wound do not respond to antibiotics in cases with ulcer, some rare etiological agents should be considered. [Dis Mol Med 2016; 4(3.000): 34-36]

The rose bengal test is often used for rapid diagnosis of human brucellosis in endemic areas. However, autoantibodies have never been investigated as a reason for false-positive or false-negative results. Therefore, the aim of this study was to show the effect of autoantibody detection on the rapid diagnosis of human brucellosis in an endemic area. The study included 2 groups: antinuclear antibody (ANA)-positive and ANA-negative groups. Diagnosis of brucellosis was established by isolation of Brucella spp. from blood culture. The overall sensitivity and specificity of the rose bengal test were 100% and 90.8%, respectively. The specificity (100% versus 89%) and positive predictive value of the test (100% versus 8%) fell markedly from the ANA-negative to the ANA-positive group. As a conclusion, this study verified our suspicion about the effect of autoantibodies on rose bengal test results to the diagnosis of human brucellosis. However, to have definite decisions, extensive studies with larger populations are needed.