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Introduction: Campylobacter infections are among the most common causes of bacterial enteritis. This study aims to determine the sensitivity, specificity and positive predictive values (PPV) of culture and culture-independent tests for the diagnosis of Campylobacter enteritis. Methodology: A total of 400 stool samples were included in the study. BD MAX enteric bacterial panel (BD Diagnostics, Franklin Lakes, NJ, USA) and EntericBio Gastro Panel II (Serosep, Limerick, Ireland) were used as commercial molecular tests. RIDA®QUICK Campylobacter (R-Biopharm, Darmstadt,, Germany) and CerTest (Biotec, Zaragoza, Spain) were used to detect Campylobacter antigens. Samples were cultured in CCDA media and subjected to bacterial identification by mass spectrometry. Results: Among the 400 specimens, 41 (10.2%) were evaluated as Campylobacter positive; 21 were culture-positive and 20 were detected as positive by both PCR methods. Of the 21 isolates grown in culture, 16 (76.2%) were identified as C. jejuni and 5 (23.8%) as C. coli. While all 21 culture-positive specimens were detected as positive by both molecular tests, 18 of the specimens were found positive by RidaQuick, and 16 by Certest ICA. Of the 20 culture-negative Campylobacter cases, 18 were positive by RidaQuick and 12 by Certest ICA. Sensitivities of culture, ICA-RidaQuick and ICA-CerTest were 51.2%, 87.8 and 68.3, respectively. The specificities of all tests were in the range of 90-100 %. PPV of molecular tests, ICA-RidaQuick and ICA-CerTest were > 95%, 72 % and 48.3 %, respectively. Conclusions: Molecular tests were superior to culture and ICA in terms of sensitivity, specificity, and positive predictive value.

Amaç: Kandidemi yoğun bakım ünitelerinde yatan kritik hastalarda yüksek morbidite ve mortalite oranına sahiptir. Sağ kalım için doğru anti-fungal tedavinin gecikmeden başlanmasının hayati önemi vardır. Bu çalışmada, kandida türlerinin dağılımını, kandidemi için risk faktörlerini ve yıllar içinde anti-fungal dirençteki değişimi gözden geçirmek için bir Çocuk Yoğun Bakım Ünitesi (ÇYBÜ)’inde gözlenen kandidemi ataklarının 6 yıllık retrospektif analizi yapıldı.Gereç ve Yöntem: Ocak 2014- Ocak 2020 tarihleri arasında XXX Hastanesi ÇYBÜ’inde yatan hastalarda gözlenen kandidemi atakları incelendi. Hastaların demografik ve klinik özellikleri, laboratuvar bulguları, tedavileri ve sonuçları tıbbi kayıtlarından elde edildi.Bulgular: Altı yılda 59 kandidemi atağı (%54,2) olmuştu, tanı anındaki medyan yaş 43 ay (aralık 1-225), medyan hastanede kalış süresi 48 gün (aralık 3-664) idi. Hastaların tümü antibiyotik kullanmıştı, çoğunda komorbidite (%89,8), nazogastrik tüp (84,7), santral venöz kateter (%78,0) ve mekanik ventilasyon (%76,3) vardı. Otuz altı kandidemi epizodunda etken olan kandida türleri tanımlanmıştır; bu atakların %47,2’si C. parapsilosis, %38,9’u C. albicans, %8,3’ü C glabrata, %2,8’i C lusitaniae ve %2,8’i C. tropicalis’den kaynaklanmıştı. Non-albicans kandidemili hastalarda albicans kandidemili hastalara göre hastanede kalış süresi daha uzundu ve bu hastaların tanı anında lökosit sayısı daha yüksekti. Yıllar geçtikçe anti-fungal direnç oranında artış vardı, ancak istatiksel olarak anlamlı fark yoktu. Genel olarak, otuz günlük ölüm oranı%16,9 idi.Sonuç: Belirgin derecede yüksek lökosit sayısı ve uzun hastanede kalış süresi olan kritik hastalarda, başlanacak ampirik antifungal tedavi antifungal direnci olabilen nonalbicans candida'yı kapsamalıdır, Aim: Candidemia has high morbidity and mortality rate in critically ill patients hospitalized in intensive care units. Prompt initiation of accurate anti-fungal therapy is essential for survival. In this study, a 6-year retrospective candidemia analysis of pediatric intensive care unit (PICU) was performed to review candida species distribution, risk factors for candidemia and change in the antifungal resistance in years. Material and Method: The candidemia episodes of children followed in the PICU of XXX Hospital between January 2014 and January 2020 were analyzed. The demographic and clinical characteristics, laboratory findings, treatments and outcomes of the patients were obtained from the medical records.Results: Fifty-nine episodes of candidemia (54.2% female) were reported in six years, median age at diagnosis was 43 months (range 1-225), median hospital stay was 48 days (range 3-664). All patients had used broad-spectrum antibiotics, majority had comorbidities (89.8%), nasogastric tube (84.7), central venous catheter (78.0%), and on mechanic ventilation (76.3%). Type of candida species was identified in 36 episodes of candidemia; 47.2% of these episodes were caused by C. parapsilosis, 38,9% by C. albicans, 8.3% by C. glabrata (8.3%), 2.8% by C. lusitaniae, and 2.8% by C. tropicalis. Length of hospital stay was longer among patients with nonalbicans candidemia, and these patients had higher leucocyte count at diagnosis. The rate of antifungal resistance increased over the years. Overall, thirty-day mortality rate was 16.9%.Conclusion: For critically ill patients with markedly elevated leucocyte count and long hospital stay, empiric antifungal treatment should cover nonalbicans candida with antifungal resistance.

Aim: Candidemia has high morbidity and mortality rate in critically ill patients hospitalized in intensive care units. Prompt initiation of accurate anti-fungal therapy is essential for survival. In this study, a 6-year retrospective candidemia analysis of pediatric intensive care unit (PICU) was performed to review candida species distribution, risk factors for candidemia and change in the antifungal resistance in years. Material and Method: The candidemia episodes of children followed in the PICU of XXX Hospital between January 2014 and January 2020 were analyzed. The demographic and clinical characteristics, laboratory findings, treatments and outcomes of the patients were obtained from the medical records. Results: Fifty-nine episodes of candidemia (54.2% female) were reported in six years, median age at diagnosis was 43 months (range 1-225), median hospital stay was 48 days (range 3-664). All patients had used broad-spectrum antibiotics, majority had comorbidities (89.8%), nasogastric tube (84.7), central venous catheter (78.0%), and on mechanic ventilation (76.3%). Type of candida species was identified in 36 episodes of candidemia; 47.2% of these episodes were caused by C. parapsilosis, 38,9% by C. albicans, 8.3% by C. glabrata (8.3%), 2.8% by C. lusitaniae, and 2.8% by C. tropicalis. Length of hospital stay was longer among patients with nonalbicans candidemia, and these patients had higher leucocyte count at diagnosis. The rate of antifungal resistance increased over the years. Overall, thirty-day mortality rate was 16.9%. Conclusion: For critically ill patients with markedly elevated leucocyte count and long hospital stay, empiric antifungal treatment should cover nonalbicans candida with antifungal resistance.

Introduction: Acute gastroenteritis (AGE) agents vary according to the hygiene and sanitation conditions of the regions and age groups of the patients. Rotavirus is the most commonly reported agent in all ages, whereas adenovirus is usually detected in sporadic cases. Giardia lamblia is a common gastroenteritis protozoa worldwide. The incidence of giardiasis approaches 40% in regions with insufficient sanitation and hygiene conditions. Amibic colitis is a parasitic infection caused by Entamoeba histolytica. Metronidazole is a synthetic 5-nitroimidazole affecting anaerobic bacteria and protozoa. Unnecessary usage of metronidazole, which is widely prescribed in the treatment of amebiasis and giardiasis, may lead to antibiotic resistance as well as intestinal dysbiosis. In this study, we investigated rotavirus, adenovirus, G. lamblia and E. histolytica in the stool samples and metronidazole presciption of AGE patients admitted to our hospital. Materials and Methods: The fecal samples of 8874 patients (6 months-16 years) admitted to Diyarbakir Pediatrics Hospital with the diagnosis of AGE were retrospectively analyzed. Rotavirus, adenovirus, G. lamblia and E. histolytica/dispar agents were investigated by Enzyme Immun Assay (EIA) method using RIDASCREEN® (R-biopharm AG, Germany) commercial kits. Fresh stool samples were also evaluated for G. lamblia and Entamoeba cyst and trophozoites by native-lugol (NL) method. Results: Among the 8874 samples, G. lamblia (1730 samples, 19.5%) was the most common agent followed by rotavirus (1083 samples, 12.2%). Adenovirus and E. histolytica/dispar were detected in 276 (3.1%) and 189 (2.2%) samples, respectively. Among the 3162 patients who were prescribed with metronidazole, G. lamblia, rotavirus, E. histolytica/dispar and adenovirus was found in 1730, 124, 194 and 35 patients, respectively. Metronidazole was prescribed in 1238 (17.8%) of the 6950 patients who were not diagnosed as giardiasis or amoebiasis by laboratory methods. Conclusion: Metronidazole prescription rate without laboratory findings of giardiasis or amoebiasis was high in our hospital. The proper use of laboratory methods in the diagnosis of acute gastroenteritis and the regulation of treatment after laboratory-based diagnosis will reduce unnecessary antibiotics usage.

Background: Brucellosis is a zoonotic disease caused by Brucella species. Although brucellosis is considered as an occupational disease in adults, recently it has become an infectious disease affecting all age groups, including children. Molecular epidemiological studies are crucial for control and treatment of disease in children. Objectives: This study aimed at identifying Brucella species, to detect antibiotic susceptibilities and define transmission dynamics between the Brucella isolates in children. Methods: A total of 77 Brucella isolates were identified by conventional and polymerase chain reaction methods. Anti - biotic susceptibilities were investigated by E - test strips. The isolates were genotyped by using multiple locus variable number tandem repeat analysis (MLVA) (MLVA - 16 Orsay), including 8 mini - satellite (panel 1) and 8 microsatellite (panel 2A and 2B) markers. Results: The mean age was 9.14 ± 3.4 years. All patients had been consuming unpasteurized milk. All isolates were Brucella melitensis biovar 3. Only 2 isolates were resistant to ceftriaxone, while the other isolates were susceptible to other antimicrobial agents. The MLVA - 16 typing revealed 42 MLVA profiles. Eighteen profiles included 2 or more isolates, indicating a clustering rate of 66.7%. Twenty - four isolates showed a unique profile. Single locus, double locus, and 3 locus variants were detected in 32, 26, and 15 isolates, respectively. Bruce 30, Bruce 16, Bruce 9, Bruce 7, and Bruce 4 were highly discriminatory loci, respectively. All strains were defined as genotype 122, according to MLVA - 11, and genotype 43 according to MLVA - 8, and were in the Eastern Mediterranean genotype. Conclusions: High clustering rate revealed that brucellosis among the children mainly resulted from common sources. Controlling animal movements and avoiding contaminated milk products have an importance to interrupt spread of brucellosis in children.

To identify the frequency of bacterial growth, the most commonly grown bacteria and their antibiotic susceptibility, and risk factors for bacterial colonization in bile collected from patients with different biliary diseases.This prospective study was conducted between April 2010 and August 2011. Patients with various biliary disorders were included. Bile was aspirated by placing a single-use, 5F, standard sphincterotome catheter into the bile duct before the injection of contrast agent during endoscopic retrograde cholangiopancreaticography (ERCP). Bile specimens were transported to the microbiology laboratory in blood culture bottles within an anaerobic transport system. Bacteria were cultured and identified according to the standard protocol used in our clinical microbiology laboratory. The susceptibilities of the organisms recovered were identified using antimicrobial disks, chosen according to the initial gram stain of the positive cultures.Ninety-one patients (27% male, mean age 53.7 ± 17.5 years, range: 17-86 years) were included in the study. The main indication for ERCP was benign biliary disease in 79 patients and malignant disease in 12 patients. The bile culture was positive for bacterial growth in 46 out of 91 (50.5%) patients. The most frequently encountered organisms were Gram-negative bacteria including Escherichia coli (28.2%), Pseudomonas (17.3%) and Stenotrophomonas maltophilia (15.2%). There were no significant differences between patients with malignant and benign disease (58% vs 49%, P = 0.474), patients with acute cholangitis and without acute cholangitis (52.9% vs 50%, P = 0.827), patients who were empirically administered antibiotics before intervention and not administered (51.4% vs 60.7%, P = 0.384), with regard to the bacteriobilia. We observed a large covering spectrum or low resistance to meropenem, amikacin and imipenem.We did not find a significant risk factor for bacteriobilia in patients with biliary obstruction. A bile sample for microbiological analysis may become a valuable diagnostic tool as it leads to more accurate selection of antibiotics for the treatment of cholangitis.