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WOS: 000408311400011, PubMed ID: 28929967, Colistin is a polymyxin antibiotic which is considered as one of the last line agents against infections due to multidrug resistant or carbapenem resistant gram-negative pathogens. Colistin resistance is associated with chromosomal alterations which can usually cause mutations in genes coding specific two component regulator systems. The first plasmid-mediated colistin resistance gene, mcr-1 was described in Escherichia coli and Klebsiella pneumoniae isolates in December 2015 and followed by another plasmid-mediated colistin resistance gene mcr-2 in 2016. The rapid and interspecies dissemination of plasmid-mediated resistance mechanisms through horizontal gene transfer, have made these genes considerably threatening. After the first reports, although mcr-1/mcr-2 producing Enterobacteriaceae isolates have been reported from many countries, there have been no reports from Turkey. Thus, the aim of this study was to investigate the presence of mcr-1/mcr-2 in clinical Enterobacteriaceae isolates from different parts of our country. A total of 329 Enterobacteriaceae isolates from 22 laboratories were collected which were isolated between March, 2015 and February, 2016. mcr-1/mcr-2 were investigated by polymerase chain reaction during February-March, 2016. Two hundred and seventeen of Klebsiella pneumoniae (66%), 75 of Salmonella spp. (22.8%), 31 of Esherichia coli (9.4%), 3 of Enterobacter cloacae (0.9%), 2 of Klebsiella oxytoca (0.6%) and 1 of Enterobacter aerogenes (0.3%) isolates were included to the study. Agarose gel electrophoresis results of PCR studies have shown expected band sizes for positive control isolates as 309 bp for mcr-1 and 567 bp for mcr-2. However, the presence of mcr-1/mcr-2 genes was not detected among the tested study isolates of Enterobacteriaceae. Although mcr-1/mcr-2 were not detected in our study isolates, it is highly important to understand the mechanism of resistance dissemination and determine the resistant isolates by considering that colistin is a last-line antibiotic against infections of multidrug or carbapenem resistant gram-negative bacteria. Thus, it is suggested that these mechanisms should be followed-up in both clinical and non-clinical (e.g. isolates from food animals, raw meats and environment) isolates of special populations.

WOS: 000472129100006, Myroides sp is a rare cause of infection, which can be fatal. Myroides spp isolates were obtained from urinal specimens of in- and out-patients attending a hospital in Turkey during July 2015 to November 2017. Myroides sp identification was based on colony morphology, biochemical properties and partial sequence of 16S rDNA, revealing the presence of M. odoratus. Antibiogram profiles showed almost all Myroides sp strains from in-patients (n = 11) were resistant to 13 antibiotics tested except for 50% that were intermediate resistant to tigecycline, whereas strains from out-patients (n = 4) were susceptible or intermediate susceptible. However, all Myroides sp strains lacked the six carbapenem resistance genes examined. Pulse-field gel-electrophoresis demonstrated clonality among four strains from in-patients. Clinical features of five in-patients and two outpatients isolates were believed to be due to Myroides infection and were treated accordingly; however, two died. Two out-patients believed to be infected recovered completely upon treatment. Ten in-patients had renal problems and all outpatients had urological problems or chronic renal failure. Myroides spp caused infection in both immunocompromised and immunocompetent patients in our study. Although tigecycline was used as first line treatment for Myroides-infected in-patients at this hospital, antibiograms of Myroides spp cultured from both in-and out-patients at other hospitals should be maintained to assist in prescribing appropriate antibiotics. Although Myroides infection is rare, its innate multi-drug resistance and propensity among patients with renal and urological problems warrants microbiological attention.

BACKGROUND: The aim of this study was to detect reliability of Brucella Coombs gel test (BCGT) by comparing with with ELISA (IgG + IgM), Standard agglutination test, and Brucella immunocapture agglutination methods in serological diagnosis of brucellosis. METHODS: Brucella Coombs gel test (BCGT), Brucella ELISA (IgG + IgM), Standard agglutination test, and Brucella immunocapture agglutination tests of 78 patients with presumptive diagnosis of brucellosis which were sent to Microbiology Laboratory of Konya Numune Hospital from various regions of Konya were studied. RESULTS: Results: Of 78 patients with ELISA IgG and IgM, STA, BICA and BCGT; 26, 21, 10, 12 and 12 were positive. When compared with BICA, the sensitivity and specifity of BCGT were 100% and 100%, respectively. CONCLUSION: According to results BCGT can be used as a diagnostic test in routine laboratories after more comprehensive studies in control groups and patients.

Amaç: H. pylori, gastrit, peptik ülser, gastrik kansere sebep olabilen ve midede sık rastlanan bir bakteridir. Bu çalışmanın amacı dispeptik hastalarda yeni kullanıma giren H. pylori gaita antijen (HpSA) testinin tanı değerini üre soluk testi ile kıyaslamaktır. Yöntem: Bu çalışmada hastanemizin çeşitli polikliniklerine dispeptik şikayetlerle başvuran 57 hasta çalışmaya alındı. Bu hastalardan son 1 hafta içinde proton pompa inhibitörleri, antiasit, bizmut içeren bileşikler ve 1 ay antibiyotik almayan hastalarda üre soluk testi (Heliprobe) ve gaita antijen testi rapid HpSA (Meridian Bioscience Europe, Milano, İtalya) çalışıldı. Bulgular: Çalışmaya alınan 57 hastanın 39’unda üre soluk testi pozitifken (%68.4), 18 inde (%31.6) üre soluk testi negatifti. 32 hastada gaita antijen testi pozitifken (%56.1), 25 hastada negatifti (%43.9).Gaita antijen testinin sensivitesi %82.0, spesifitesi %100, pozitif prediktif değeri %100, negatif prediktif değeri %72.0 idi. Sonuç: Üre soluk testi tek başına H. pylori tanısında kullanılabilmektedir. Gaita antijen testi dispepsisi olan kişilerde tanı ve tedavi takibinde kullanılabilir. Tek başına dispeptik şikayetleri olmayan hastalarda tanı koydurucu değildir ve diğer testlerle beraber kullanılması faydalıdır

Amaç: Çoğunlukla fekal-oral yol ile bulaşan Hepatit A virüsü geri kalmış ve gelişmekte olan ülkelerde önemli bir sağlık problemidir. Ülkemizde ulusal genişletilmiş bağışıklama programına henüz dahil edilmiştir. Bu çalışmada Konya ilinde Hepatit A virüsü için seropozitiflik oranı retrospektif olarak değerlendirildi. Gereç ve Yöntemler: Bu çalışmada 2005-2009 yılları arasında Konya ili merkez ve periferinden 1.basamak sağlık kuruluşlarına çeşitli sebeplerle başvuran bireylerde Hepatit A virüsü için seropozitiflik oranı retrospektif olarak değerlendirildi. Çalışmada 0-99 yaşlar arasındaki olgular değerlendirmeye alındı. 0-17 yaş grubu olgular ise yaş gruplarına, cinsiyet ve bölgesel özelliklere göre değerlendirildi. Bulgular: Beş yıllık sürede toplam 12888 hastanın 10042 sinde (%77) Anti-HAV IgG pozitif bulunurken, 14458 hastanın 418 inde (%2,89) Anti-HAV IgM sonucu pozitif olarak saptanmıştır. Sonuç: Beş yıllık sürede %77 oranında A nti-HAV IgG ve %2,89 oranında Anti-HAV IgM pozitifliği saptanmıştır. Konya periferinde diğer merkez ilçelere göre anlamlı derecede yüksek pozitifliğe rastlanmıştır. Sosyoekonomik seviyesi yüksek olan Merkez Meram ilçesinde ise HAV IgM pozitifliği en düşük seviyede bulunmuştur. HAV IgG pozitifliği açısından yapılan çoklu karşılastırmalar sonucunda Konya periferinde pozitiflik oranının daha yüksek olduğu görülmüştür. Hepatit A özellikle pediatrik yaş grubunda önemli bir sağlık problemidir. Çalışmamız geniş bir populasyonu kapsadığından dolayı Konya ilinin Hepatit A yönünden serolojik durumu hakkında yol gösterici olabilir., Objective: Hepatitis A virus which is usually transmitted by the fecal-oral route is a major health problem in underdeveloped and developing countries. In our country, it has been yet included in the national expanded immunization program. In this study, the seropositivity of hepatitis A infection in Konya were evaluated retrospectively. Materials and Methods: In this study, the seropositivity of hepatitis A infection of individuals who had attended to primary care provider from central and peripheral districts of Konya from January 2005 to December 2009 were evaluated retrospectively. In this study the 0-99 age group were evaluated. Age groups 0-17 were evaluated according to age group, gender, and regional characteristics. Results: A total of 12,888 individuals, 10,042 (77%) were positive for anti-HAV IgG; A total of 14458 patients, 418 (2.89%) were positive for anti-HAV IgM. Conclusion: During the 5 years period; in total 77% were positive for HAV IgG and 2.89% were positive for HAV IgM. The positivity rate was significantly found higher in the periphery than other districts of Konya. Also in one of the central districts of Konya, Meram which has high socio-economic level; the rate of HAV IgM positivity was found at the lowest level. As a result of the multiple comparisons, it was seen that HAV IgG positivity rate was higher in the periphery of Konya. Hepatitis A is a major health problem particularly in the pediatric age group. As our study covers a large population, it may guide about the serological status of hepatitis A in Konya.

Çeşitli klinik örneklerden izole edilen 150 Pseudomonas aeruginosa suşunun sefoperazon-sulbaktam, imipenem, meropenem, siprofloksasin, amikasin ve piperasilin-tazobaktama direnci Kirby-Bauer disk difüzyon yöntemi ile araştırılmıştır. Dirençli suşların oranı sefoperazon-sulbaktama % 63.3, imipeneme % 57.3, meropeneme % 50.6, siprofloksasine % 46.6, amikasine % 33.3, piperasilin-tazobaktama % 31.3 olarak bulunmuştur. Sonuç olarak; hastanemizde P.aeruginosa’nın antibiyotiklere direnç oranı yüksektir. Dolayısıyla ampirik tedavi planlanırken direnç oranları göz önünde bulundurulmalıdır., Antibiotic resistance of 150 Pseudomonas aeruginosa strains isolated from various clinical specimens were determined. The rates of resistance were as follows: to cefoperazone-sulbactam 63.3 %, to imipenem 57.3 %, to meropenem 50.6 %, to ciprofloxacin 46.6 %, to amikacin 33.3 %, to piperacillin-tazobactam 31.3 %. In conclusion, resistance of P.aeruginosa isolates to antimicrobials is high in our hospital. So, these resistance rates should be considered for empirical treatment.

Escherichia coli idrar yolu infeksiyonlarında en çok izole edilen patojendir. Çalışmamızda idrardan izole edilen 178 E.coli suşunun CLSI kriterleri temel alınarak Kirby-Bauer disk difüzyon yöntemi ile ampisilin, trimetoprim/sülfametoksazol, ampisilin/sulbaktam, sefuroksim, siprofloksasin, nitrofurantoin, amikasin, gentamisin ve imipeneme duyarlılıkları araştırılmıştır. İmipeneme 178 (% 100), amikasine 157 (% 88.2), nitrofurantoine 151 (% 84.8), gentamisine 129 (% 72.5), sefuroksime 124 (% 69.7), siprofloksasine 111 (% 62.4), ampisilin/sulbaktama 92 (% 51.7), trimetoprim/sülfametoksazole 79 (% 44.4) ve ampisiline 39 (% 21.9) suş duyarlı bulunmuştur., Escherichia coli is the most common bacterium isolated from urinary tract infections. In this study the antibiotic susceptibility of 178 uropathogenic E.coli strains was determined by Kirby-Bauer disk diffusion test. The antimicrobial susceptibility rates were for as follow: imipenem 100 %, amikacin 88.2 %, nitrofurantoin 84.8 %, gentamicin 72.5 %, sefuroxime 69.7 %, ciprofloxacin 62.4 %, ampicillin/sulbactam 51.7 %, trimethoprim/sulfametoxazole 44.4 % and ampicillin 21.9 %.

Amaç: H. pylori, gastrit, peptik ülser, gastrik kansere sebep olabilen ve midede sık rastlanan bir bakteridir. Bu çalışmanın amacı dispeptik hastalarda yeni kullanıma giren H. pylori gaita antijen (HpSA) testinin tanı değerini üre soluk testi ile kıyaslamaktır. Yöntem: Bu çalışmada hastanemizin çeşitli polikliniklerine dispeptik şikayetlerle başvuran 57 hasta çalışmaya alındı. Bu hastalardan son 1 hafta içinde proton pompa inhibitörleri, antiasit, bizmut içeren bileşikler ve 1 ay antibiyotik almayan hastalarda üre soluk testi (Heliprobe) ve gaita antijen testi rapid HpSA (Meridian Bioscience Europe, Milano, İtalya) çalışıldı. Bulgular: Çalışmaya alınan 57 hastanın 39’unda üre soluk testi pozitifken (%68.4), 18 inde (%31.6) üre soluk testi negatifti. 32 hastada gaita antijen testi pozitifken (%56.1), 25 hastada negatifti (%43.9).Gaita antijen testinin sensivitesi %82.0, spesifitesi %100, pozitif prediktif değeri %100, negatif prediktif değeri %72.0 idi. Sonuç: Üre soluk testi tek başına H. pylori tanısında kullanılabilmektedir. Gaita antijen testi dispepsisi olan kişilerde tanı ve tedavi takibinde kullanılabilir. Tek başına dispeptik şikayetleri olmayan hastalarda tanı koydurucu değildir ve diğer testlerle beraber kullanılması faydalıdır. Objective: Helicobacter pylori (H. pylori) is the most common pathogen found in gastric mucosa and can cause gastritis, peptic ulcus and gastric cancer. The aim of this study was to compare and evaluate the effect of the urea breath test which has a high sensitivity and specifity with a new test; stool antigen test. Method: Fifty-seven patients with dispepsia who had admitted gastroenterology department were included in this study. Patients who received acid supressing drugs, antibiotics, proton pump inhibitors and drugs containing bizmut due to any reason for one month before undergoing urea breath test were excluded from the study. Hp stool antigen rapid HpSA (Meridian Bioscience Europe, Mila¬no, Italy) and Urea breath test (Heliprobe) were investigated in all patients. Results: The urea breath test was positive in thirty-nine patients (%68.4) and was negative in eighteen patients (%31.6). The stool antigen test was positive in thirty-two patients (%56.1) and was negative in twenty-five patients (%43.9). The sensitivity, specificity, positive and negative predictive values of HpSA were 82.0%, 100%, 100% and 72.0%, respectively. Conclusion: The urea breath test can be used for the diagnosis of H. pylori infection. Rapid HpSA can be used for dyspeptic patient for diagnosing H. pylori infection but in nondyspeptic patient isn’t sufficient test alone and can be useful in combination with the other tests.