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© TÜBİTAKAnthrax, which is primarily a disease of herbivores, is known to infect many animal species. In order to break the cycle of anthrax infection, it is important to identify the potential hosts or reservoirs of its causative agent. Therefore, this study aimed to characterize Bacillus anthracis isolates recovered from a variety of hosts and environments during anthrax sporadic in the Kars and Kayseri regions of Turkey. For this purpose, a total of 23 B. anthracis field isolates obtained from human, cattle, sheep, dog, horse, puma, soil, and fodder were used. In addition, the Sterne vaccine strain was included. All B. anthracis isolates were confirmed via molecular tests using plasmid-based PCR and 16S rRNA gene sequencing. All were found to be positive for protective antigen (PA) and capsule (Cap) genes. The presence of two specific 16S rRNA positions (1139 and 1148) with nucleotide mismatches was used to differentiate between B. anthracis species in the Bacillus cereus group, which has a relatively high (>99%) 16S rRNA sequence similarity. All of our isolates, including the Sterne vaccine strain, were classified in the same 16S rRNA type (Type 6) that has been reported previously as being the predominant type for B. anthracis isolates.

The diversity and distribution of TEM, SHV and CTX-M type of extended-spectrum beta-lactamases (ESBLs) are important for the treatment and control of infections. Determination of ESBL genes in clinical isolates by polymerase chain reaction (PCR) and DNA sequencing can obtain useful data for their molecular epidemiology and risk. The aim of this study was to investigate the frequency of beta-lactamase genes in Acinetobacter baumannii strains isolated from different regions of Turkey. A total of 519 A. baumannii strains collected from hospitals located at 12 different provinces of Turkey (Bolu (n=67), Tokat (n=47), Trabzon (n=25), Ordu (n=27), Diyarbakir (n=47), Nigde (n=31), Kayseri (n=36), Ankara (n=41), Kirikkale (n=26), Kahramanmaras (n=25), Mersin (n=40), Istanbul (n=107)] between 2011-2012 period were included in the study. Identification of the isolates were performed by both conventional methods and automated systems, VITEK2 Compact (BioMerieux, France) and API 32GN (BioMerieux, France). Disc diffusion method was used for the detection of antibiotic susceptibilities of the isolates and the results were evaluated according to CLSI (Clinical and Laboratory Standards Institute) criteria. Tigecycline and colistin sensitivities of the isolates were evaluated according to BSAC (British Society for Antimicrobial Chemotherapy) criteria. The presence of beta-lactamase genes, namely bla(oxa-51), bla(TEM), bla(SHV), bla(CTX-M1), bla(CTX-M2), bla(GES) and bla(VIM) were detected by PCR. In our study, the resistance rates against colistin, tigecycline, ampicillin-sulbactam, amoxicillin-clavulanic acid, cefoperazone/sulbactam, tobramycin, ceftriaxone, piperacillin-tazobactam, gentamicin, ampicillin, tetracycline, cefepime, piperacillin, amikacin, trimethoprim-sulfamethoxazole, meropenem, levofloxacin, ciprofloxacin, imipenem and ceftazidime were detected as; 0.6%, 2.7%, 11.9%, 15.2%, 21%, 22.9%, 23.9%, 48.6%, 59.5%, 61.8%, 66.3%, 67.8%, 69.2%, 71.1%, 77.5%, 78.6%, 81.1%, 82.9%, 87.5% and 89.4%, respectively. All of the isolates (100%) were OXA-51 positive, while 443 (85.4%) out of 519 strains harbored other beta-lactamase genes searched in the study. When the distribution of the genes were evaluated, bla(TEM-1) was found as the predominant one with a frequency rate of 55.7% (n=289/519), followed by bla(CTX-M2) (63/519, 12.1%), bla(CTX-M1) (42/519, 8.1%), bla(SHV) (40/519, 7.7%), bla(GES) (8/519, 1.5%) and bla(VIM) (1/519, 0.2%). Cooccurence of ESBL genes was detected in 16.3% (72/443) of the strains, being mostly TEM+CTX-M2 (20/72, 27.8%), TEM+SHV (11/72, 15.3%) and TEM+CTX-M1 (10/72, 13.9%). In addition, it was noted that the distribution of ESBL genes between isolates showed differences according to the provinces. Accordingly, none of the strains isolated from four provinces (Bolu, Nigde, Mersin, Kahramanmaras) and from three provinces (Bolu, Kahramanmaras, Diyarbakir) harbored bla(CTX-M1/M2) and bla(SHV) genes, respectively. The bla(TEM) gene was detected in isolates collected from all of the provinces, with a highest frequency in Nigde (28/31, 90.3%) and lowest in Trabzon (1/25, 4%). The presence of GES-11 type ESBLs was found only in the isolates sent from Nigde province (8/31; 25.8%). Screening of metallo-beta-lactamase VIM gene also yielded a single positive result amongst only Nigde isolates (1/31; 3.2%), and this gene was identified as VIM-5 type by DNA sequencing.

In Turkey, genotype 1, especially type 1b virus, causes approximately 90% of these infections, while types 2, 3, and 4 exist, albeit in low prevalences and are due to relatively recent and limited introductions. Two recent reports from Kayseri, a relatively large city in Central Anatolia, indicated unusually high prevalence for type 4 infections in the province reaching a 35% among patients admitted to hospitals for treatment of chronic hepatitis C. In this study, the origin, the demographic history, and the dynamic of the epidemic of unusual HCV genotype 4d in Turkey by using Bayesian coalescent-based method were investigated. A gene flow migration approach was also used to describe the synchronous geographical dispersal and genetic diversification of this unusual genotype in Kayseri province. The Turkish clade had a tMRCA of 44 years corresponding to the year 1967 and seems to have a different origin being completely segregated from the European one. Gene flow migration analysis indicated that Kayseri province appeared to be the epicenter of HCV-4d epidemic, exporting the infections. The demographic history of HCV-4d showed that the epidemic started in 1970s year then following a slow exponential growth until 1980s. The Turkish monophyletic clade suggests a segregate circulation of the epidemic in this region mostly due to unsafe parenteral medical procedures (with drug addiction playing a relatively negligible role). J. Med. Virol. 86:454-460, 2014. (c) 2013 Wiley Periodicals, Inc.

Bu çalışmada, ülkemizdeki invazif A grubu streptokok (AGS) enfeksiyonlarının epidemiyolojik ve mikrobiyolojik özelliklerinin belirlenmesi ve bu hastalıkların önlenmesinde uygulanacak olan ulusal stratejilere veri sağlanması amacıyla bir yıllık aktif sürveyans yapılması planlanmıştır. Çalışmaya, Türkiye’nin 12 farklı bölgesinden (İstanbul; Doğu ve Batı Marmara; Doğu ve Batı Karadeniz; Ege; Akdeniz; Batı, Orta, Kuzeydoğu, Ortadoğu ve Güneydoğu Anadolu) toplam 46 klinik mikrobiyoloji laboratuvarı katılmıştır. Katılımcı merkezlerde, Haziran 2010-Haziran 2011 tarihleri arasında steril vücut bölgelerinden (kan, beyin omurilik sıvısı, eklem, plevra, periton, perikard sıvıları) izole edilen AGS’ler, doğrulama ve ileri çalışmalar için Maltepe Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı Laboratuvarına gönderilmiştir. Bakterilerin tanımlanması konvansiyonel yöntemlerle yapılmış; serotiplendirme için opasite faktörü (OF) ve T protein tipleri araştırılmış, genotiplendirme için AGS lizatı hazırlama, emm geni amplifikasyonu ve dizilenmesi, “Centers for Disease Control and Prevention” protokolüne göre uygulanmıştır. Çalışma dönemi içinde katılımcı merkezlerin 15’inden, 65 invazif AGS suşu izole edilmiştir. İnvazif AGS izolasyon oranının bölgesel farklılıklar gösterdiği belirlenmiş, en yüksek izolasyonun Doğu Karadeniz (Trabzon; n 19) bölgesinde olduğu, bunu İstanbul (n 17) ve Batı Anadolu (Ankara, Konya; n 14) bölgelerinin izlediği görülmüştür. İnvazif AGS enfeksiyonu tanısı konulan hastaların 33’ü kadın, 32’si erkek olup, yaş aralığı 0-89 yıl arasındadır. AGS suşlarının en fazla yumuşak doku (n 18), apse (n 10), steril vücut sıvısı (n 8) ve kan (n 7) örneklerinden izole edildiği gözlenmiştir. Serotiplendirme sonucunda 36 (%55) izolatın OF pozitif olduğu saptanmış; en sık saptanan T protein tipleri poligrup T (n 20) ve U (n 14) olmuş, bunları B (n 5), X (n 3) ve Y (n 2) izlemiştir. Yirmi iki izolatta T proteini tespit edilememiştir. Genotiplendirme sonucunda izolatların 17 farklı emm tipine sahip olduğu saptanmış; en sık rastlanan tipler; emm1 (n 13), emm4 (n 6), emm6 (n 6), emm12 (n 6), emm24 (n 4), emm14 (n 3) ve emm28 6 (n 3) olarak belirlenmiş, dokuz suş dizileme ile tiplendirilememiştir. İzolatların emm tipleri ile serotipleri arasındaki korelasyon %58 olarak bulunmuştur. Kullanımdaki 26 değerli aşının invazif AGS suşlarının %70.5’ini kapsadığı tespit edilmiştir. Sonuç olarak bu çalışmayla Türkiye’de invaziv AGS enfeksiyonlarının epidemiyolojik ve mikrobiyolojik özellikleriyle ilgili ilk veriler elde edilmiştir. İnvazif AGS enfeksiyon sıklığının ülkemizde düşük olduğu, 26 değerli ASG aşısının aşı programına dahil edilmesinin ülkemiz için şu anda acil halk sağlığı sorunu olmadığı ve eğer ülkemizde kullanılacaksa aşıya emm4 ve emm24 tiplerinin de eklenmesi gerektiği ortaya çıkmıştır., A one-year active surveillance study was conducted to investigate the epidemiological and microbiological characteristics of invasive group A streptococci (GAS) infections in Turkey and to provide data for the establishment of national preventive strategies related to invasive GAS infections. A total of 46 clinical microbiology laboratories from 12 different regions of Turkey (Istanbul; Eastern and Western Marmara; Eastern and Western Blacksea; Aegean; Mediterranean; Western, Central, Northeastern, Middle-eastern and Southeastern Anatolia) participated in the study. Accordingly, GAS strains isolated from sterile body sites (blood, cerebrospinal, synovial, pleural, peritoneal, pericardial fluids) in the study centers between June 2010-June 2011, were sent to Maltepe University Hospital Clinical Microbiology Laboratory for microbiological confirmation and further analysis. The isolates were identified by con- ventional methods, and for serotyping, opacity factor (OF) and T protein types were investigated. For genotyping GAS lysate preparation, emm gene amplification and sequencing were performed by using the protocols recommended by Centers for Disease Control and Prevention. A total of 65 invasive GAS strains were isolated in 15 of the participant centers, during the study period. The rate of invasive GAS isolation exhibited regional variation, with the highest rates in the Eastern Blacksea (Trabzon, n 19), followed by Istanbul (n 17) and Western Anatolia (Ankara, Konya, n 14). Of the patients with invasive GAS infection 33 were female, 32 were male, with the age range of 0-89 years. GAS strains were most commonly isolated from soft tissue specimens (n 18), followed by abscess material (n 10), sterile body fluids (n 8) and blood (n 7) samples. Serotyping revealed that 55% (36/65) of the strains were OF positive, and the majority of T protein was polygroup T (n 20), followed by U (n 14), B (n 5), X (n 3) and Y (n 2). T protein was not detected in 22 isolates. The strains were found to have 17 different emm types; emm1 (n 13), emm4 (n 6), emm6 (n 6), emm12 (n 6), emm24 (n 4), emm14 (n 3) 6 and emm28 (n 3). Nine of the strains could not be typed by sequencing. The correlation between emm typing and serotyping was detected as 58%. It was observed that 26-valent vaccines included 70.5% of the invasive GAS strains included in this study. Our study provided initial data concerning the epidemio- logical properties of invasive GAS infections and characterization of GAS strains in Turkey. The incidence of invasive GAS infections is low in our country. Although immunization programme by 26-valent GAS vaccine is not currently an urgent public health issue for our country, the results of this study indicated that emm types 4 and 24 should better be included in such a vaccine to be used in Turkey. Additionally, since epidemiological features of GAS infections and the microbiological characteristics of the strains can vary by time, for the diagnosis of invasive streptococcal infections and to take the necessary preventive measures, epidemiological studies should be conducted repeatedly.

GBS'lar 1960'lardan beri sepsis ve menenjitle seyreden ciddi yenidoğan infeksiyonlarının önemli bir nedenidir. Anneden bebeğe vertikal geçiş intrauterin asenden yolla ve doğum sırasında olur. Hastane veya toplumsal kaynaklı infeksiyonlar daha azdır. Kadınlarda GBS taşıyıcılık oranı sosyal ve coğrafi faktörlere göre değişebilir. Bu çalışma ile ülkemizde GBS kolonizasyon sıklığının saptanarak, GBS'lara bağlı neonatal ve maternal morbidite ve mortaliteyi azaltacak sağlık politikalarını geliştirmek için gerekli epidemiyolojik araştırmalara katkıda bulunulması amaçlanmıştır. Bu amaçla Eylül 2001 ile Nisan 2002 tarihleri arasında SSK Ankara Doğumevi ve Kadın Hastalıkları Eğitim Hastanesi Gebe polikliniğine başvuran 2. ve 3. trimestırdeki 183 gebe ve jinekoloji, infertilite ve aile planlaması polikliniklerine başvuran üreme dönemindeki gebe olmayan 81 kadın hasta olmak üzere toplam 264 olguda GBS taşıyıcılığı araştırılmıştır. Olgulardan vajinal ve rektal sürüntü örnekleri alınarak selektif besiyerlerine ekilmiştir. GBS taşıyıcılığı ile sosyoekonomik durum, gebelik sayısı, yaş, eğitim durumu, rahim içi araç kullanımı ve cinsel yaşam arasındaki birlikteliği araştırmak üzere her olgu için ayrı bir bilgi formu doldurulmuştur.Yüz seksen üç gebede %1.63 oranında vajinal kültürde GBS izole edilmiştir. Gebe olmayan oolgularda %1.23 oranında GBS izole edilmiştir. Toplam 264 olgudaki insidans %1.51 bulunmuştur. Hiç bir olguda rektal GBS izole edilmemiştir.Çalışma sonucunda yaş, gebelik sayısı ve eğitim durumunun taşıyıcılık oranını etkilediği, cinsel ilişki sıklığı ve RİA kullanımının taşıyıcılığa etkisi olmadığı belirlenmiştir.Sonuç olarak bu çalışmada maternal kolonizasyon oranı düşük bulunmuştur. Ayrıca her kolonize yenidoğanda GBS'lara bağlı enfeksiyon görülmemektedir.Bu koşullarda ülkemizde her gebede rutin kolonizasyon taramasının maliyet-yarar açısından çok efektif olmadığı düşünülmüştür.Ancak GBS enfeksiyonu riskini artıracak bir durum söz konusu olduğunda kolonizasyon tespiti ve tedavisinin yapılmasının daha etkin olacağı düşünülmüştür.Ülke genelinde yapılacak çok merkezli, kontrollü çalışmalarla taşıyıcılık oranı ve serotip dağılımının saptanarak, yenidoğan sepsis ve menenjitlerinde GBS sıklığının belirlenmesi ve ülkemizde bu enfeksiyonlara karşı alınması gereken önlemler için daha net veriler elde edilmesi ve bir sağlık politikasının geliştirlmesi gerektiği sonucuna varılmıştır. GBSs are among the causative organisms of serious neonatal infections with a course of sepsis and meningitis since 1960s. Vertical transmission from mother to infant is through the intrauterine ascendant route or occurs during the birth. Hospital or community-acquired infections are less frequent. The rate of GBS carriage in women can vary according to social or geographical factors.This study aims at determining the incidence of GBS colonization incidence in our country and to contribute to the epidemiologic researches required for the development of healthcare policies that will reduce neonatal and maternal morbidity and mortality related to GBSs.For this purpose, GBS carrier status was investigated in 264 cases in total, out of which 183 were pregnant women in their 2nd or 3rd trimesters who applied to SSK Ankara Obstetrics and Gynecology Hospital Pregnancy Outpatient Clinic, and 81 were non-pregnant patients in their fertile periods who had applied to gynecology, infertility or family planning outpatient clinics between September 2001 and April 2002. Vaginal and rectal swabs taken from the cases were cultured on selective media. An individual information form was filled for each patient to investigate the relation of GBS carrier status with socio-economic status, number of pregnancies, age, educational status, intrauterine device use and sexual life.GBS was isolated in vaginal culture in 183 pregnant women with a rate of 1.63%. GBS was isolated in non-pregnant women with a rate of 1.23%. Incidence in the total group of 264 cases was found as 1.51%. Rectal GBS was isolated from none of the cases.It was determined at the end of the study that age, number of pregnancies and educational status affected the carrier status, while frequency of sexual intercourse and IUD use did not affect the carrier status.In conclusion, the rate of maternal colonization rate was found low in this study. Furthermore, GBS-related infections are not seen in every colonized neonatal. It has been concluded that carrying our routine screening for colonization will not be very cost-effective in every pregnant woman in our country under such conditions.However, it is also thought that determining and treating colonization will be more effective in cases with increased risk of GBS infection.It has been concluded that the carrier status rate and serotype distribution should be determined with multicenter and controlled studies to be carried out throughout the country, GBS incidence in neonatal sepsis and meningitis cases should be determined to obtain clearer data for the measures that must be taken against such infections and a healthcare policy should be determined. 44

The objective of this study was to determine the antibiotic susceptibility of Arcobacter spp. isolated from various sources. Seventy Arcobacter spp. isolates were tested for their susceptibility to 13 antimicrobial agents. Antimicrobial susceptibility testing was performed by using the agar disc diffusion method on Mueller-Hinton agar supplemented with 5% defibrinated sheep blood. The antibiotics tested included enrofloxacin, erythromycin, streptomycin, gentamycin, rifampin, tetracycline, ampicillin, trimethoprim/sulfamethoxazole, nalidixic acid, danofloxacin, amoxycillin-clavulonic acid, cefuroxime-sodium, neomycine. Although all the arcobacters tested were susceptible to gentamycin, resistance to three or more antibacterial agents (especially, trimethoprim/sulfamethoxazole, cefuroxime-sodium and rifampin) was observed. A. butzleri isolates were found to be resistant to amoxycillin+clavulonic acid, nalidixic acid and ampicillin, at the rate of 20%, 44.28% and 78.57% respectively. In conclusion, gentamycin, streptomycin and tetracycline may be suitable antibiotics for the treatment or control of disease caused by Arcobacter spp. in veterinary and human medicine.

Background: Urine analysis is one of the most common tests for assessing urinary-tract infections, which are the most frequently occurring infectious diseases in community populations. Urine culture is still the 'gold standard' for the detection of urinary tract infection, however, it is time- and labor-intensive and and has a high number of unnecessary cultures. The aim of this study was to evaluate the analytical and diagnostic performance of a new urinalysis system LabUMat with UriSed (77 Elektronika, Budapest, Hungary) in comparison to urine culture as the reference method.