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WOS:000380249800011 PubMed: 27353587 Background & objectives: Crimean-Congo hemorrhagic fever (CCHF) is a fatal disease, caused by a tick-borne virus (Nairovirus), having a high mortality rate. The study was aimed to evaluate the risk factors, the presenting symptoms and findings of the patients with prediagnosis of CCHF disease, and to compare these variables between the CCHF-positive and CCHF-negative patients. It was also aimed to develop a scoring formula for the diagnosis of CCHF. Methods: In total, 281 patients who were admitted to the Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey between 2011 and 2015 and were prediagnosed with CCHF based on the clinical symptoms, laboratory findings and risk factors were included in the study. The definitive laboratory diagnosis of patients with prediagnosis of CCHF was ensured via molecular and serological methods. In addition, a mathematical diagnostic scoring formula was developed for enhancing the laboratory results of CCHF. Results: The ratio of certain clinical symptoms such as fever (p

Amaç: Hepatit A virüs (HAV) infeksiyonları ülkemizde ve dünyada yaygın olarak görülen önemli bir halk sağlığı problemidir. Yaş ilerledikçe enfeksiyonun belirgin hale geçtiği ve komplikasyonların arttığı kabul edilir. Bu çalışmada Bolu ilinde farklı yaş gruplarında Hepatit A seroprevalansının belirlenmesi amaçlanmıştır. Yöntem: Hastanemize 2013 yılında farklı yakınmalar nedeni ile başvuran ve elektrokemiluminesans yöntemi ile (Cobas e411 Analyzer, Roche Diagnostics, Almanya) Anti- HAV IgG testi çalışılan hastalar, hepatit A seroprevalansının belirlenmesi amacıyla çalışmaya dahil edilmiştir. Bulgular: Bir yıllık sürede, Anti-HAV IgG testi çalışılan toplam 1021 hastanın 778'inde (%77.2) seropozitiflik saptanmıştır. Olgular 0-10, 11-20, 21-30, 31-40, 41-50, 51- 60, 61-70 ve70 yaş üzeri olarak yaşlarına göre gruplandırılmıştır. Bu gruplara ait Anti-HAV IgG pozitiflik oranları sırasıyla; %48.8, %38.3, %62, %85.3, %97.2, %98.8, %97.1 ve %100 olarak bulunmuştur. Sonuç: Bu çalışma ile Bolu ilinde HAV seroprevalansı ilk kez araştırılmıştır. İlimizdeki Anti-HAV IgG seropozitiflik oranının bölgemizdeki illere yakın olduğu görülmektedir. Çalışmamız yaş ilerledikçe hepatit A virüs enfeksiyonu ile karşılaşma olasılığının arttığını ve yetişkin yaş gruplarında aşılamanın önemini göstermektedir. Amaç: Hepatit A virüs (HAV) infeksiyonları ülkemizde ve dünyada yaygın olarak görülen önemli bir halk sağlığı problemidir. Yaş ilerledikçe enfeksiyonun belirgin hale geçtiği ve komplikasyonların arttığı kabul edilir. Bu çalışmada Bolu ilinde farklı yaş gruplarında Hepatit A seroprevalansının belirlenmesi amaçlanmıştır. Yöntem: Hastanemize 2013 yılında farklı yakınmalar nedeni ile başvuran ve elektrokemiluminesans yöntemi ile (Cobas e411 Analyzer, Roche Diagnostics, Almanya) Anti? HAV IgG testi çalışılan hastalar, hepatit A seroprevalansının belirlenmesi amacıyla çalışmaya dahil edilmiştir. Bulgular: Bir yıllık sürede, Anti?HAV IgG testi çalışılan toplam 1021 hastanın 778’inde (%77.2) seropozitiflik saptanmıştır. Olgular 0?10, 11?20, 21?30, 31?40, 41?50, 51? 60, 61?70 ve70 yaş üzeri olarak yaşlarına göre gruplandırılmıştır. Bu gruplara ait Anti?HAV IgG pozitiflik oranları sırasıyla; %48.8, %38.3, %62, %85.3, %97.2, %98.8, %97.1 ve %100 olarak bulunmuştur. Sonuç: Bu çalışma ile Bolu ilinde HAV seroprevalansı ilk kez araştırılmıştır. İlimizdeki Anti?HAV IgG seropozitiflik oranının bölgemizdeki illere yakın olduğu görülmektedir. Çalışmamız yaş ilerledikçe hepatit A virüs enfeksiyonu ile karşılaşma olasılığının arttığını ve yetişkin yaş gruplarında aşılamanın önemini göstermektedir.

Objective: Hepatitis A virüs infections are common public health problem in our country and in the world. It has been known that the complications of HAV infection increases with increasing age. The aim of this study was to determine the seroprevalence rates of HAV infection in different age groups in the province of Bolu. Method: The patients who consulted to our hospital in 2013 were included in the study. Anti‐HAV IgG assays performed by using electrochemiluminescence method Cobas e411 Analyzer, Roche Diagnostics, Germany in order to determine seroprevalence of hepatitis A virüs infection. Results: In 778 77.2% out of 1021 patients who were tested for Anti‐HAV IgG during a period of one year Anti‐HAV IgG seropositivity rates were found to be 48.8%, 38.3%, 62%, 85.3%, 97.2%, 98.8%, 97.1% and 100%, in age groups of 0‐10, 11‐20, 21‐30, 31‐40, 41‐50, 51‐60, 61‐70 and > 70 years, respectively. Conclusion: In this study, Hepatitis A seroprevalence has been researched in Bolu for the first time. Anti‐HAV IgG seropositivity rate in the province of Bolu was similiar with the rate of around areas. Our study showed that risk of exposure to Hepatitis A virus infection as age increases with age, and that the vaccination has importance of in the adult age group., Amaç: Hepatit A virüs HAV infeksiyonları ülkemizde ve dünyada yaygın olarak görülen önemli bir halk sağlığı problemidir. Yaş ilerledikçe enfeksiyonun belirgin hale geçtiği ve komplikasyonların arttığı kabul edilir. Bu çalışmada Bolu ilinde farklı yaş gruplarında Hepatit A seroprevalansının belirlenmesi amaçlanmıştır. Yöntem: Hastanemize 2013 yılında farklı yakınmalar nedeni ile başvuran ve elektrokemiluminesans yöntemi ile Cobas e411 Analyzer, Roche Diagnostics, Almanya Anti‐ HAV IgG testi çalışılan hastalar, hepatit A seroprevalansının belirlenmesi amacıyla çalışmaya dahil edilmiştir. Bulgular: Bir yıllık sürede, Anti‐HAV IgG testi çalışılan toplam 1021 hastanın 778’inde %77.2 seropozitiflik saptanmıştır. Olgular 0‐10, 11‐20, 21‐30, 31‐40, 41‐50, 51‐ 60, 61‐70 ve70 yaş üzeri olarak yaşlarına göre gruplandırılmıştır. Bu gruplara ait Anti‐HAV IgG pozitiflik oranları sırasıyla; %48.8, %38.3, %62, %85.3, %97.2, %98.8, %97.1 ve %100 olarak bulunmuştur. Sonuç: Bu çalışma ile Bolu ilinde HAV seroprevalansı ilk kez araştırılmıştır. İlimizdeki Anti‐HAV IgG seropozitiflik oranının bölgemizdeki illere yakın olduğu görülmektedir. Çalışmamız yaş ilerledikçe hepatit A virüs enfeksiyonu ile karşılaşma olasılığının arttığını ve yetişkin yaş gruplarında aşılamanın önemini göstermektedir.

KOSTAKOGLU, UGUR/0000-0002-4589-0962; SANDALLI, Cemal/0000-0002-1298-3687 WOS: 000408494600002 Aim - the present study aimed to detect mecA and staphylococcal cassette chromosome mec (SCCmec) types in methicillin-resistant Staphylococcus aureus (MRSA) isolates obtained from various clinical samples in two university hospitals. It was also aimed to make comparison amongst the isolates. Materials and Methods - A total of 99 MRSA strains isolated from various clinical samples between 2011-2015 were included in the study. Bacterial deoxyribonucleic acid (DNA) was extracted from Staphylococcus aureus strains using GF-1 DNA extraction Kit (Vivantis, Malaysia). mecA gene were detected, and SCCmec cassette types were determined by multiplex polymerase chain reaction (PCR) first, and following specific PCR. Specific MRSA strains such as COL type I, PER3 type Ia, and HU25 type IIIa were used as the quality control strains for optimization of multiplex PCR. the amplification products were electrophoresed using agarose gel electrophoresis in TAE buffer (mixture of tris base, acetic acid and ethylenediaminetetraacetic acid). Results - mecA gene was detected in 60 Staphylococcus aureus isolates, and these were identificated as MRSA. Amongst the MRSA strains, SCCmec type III was the most frequent cassette type (42 isolates, 70.0%). SCCmec type I was detected in 27 isolates (45.0%), type II was in 26 isolates (43.3%), and type V in 23 isolates (38.3%). Conclusion - in the present study, the most frequent cassette was detected as SCCmec type III in concordance with the studies conducted in Turkey and in some regions in the world. in conclusion, determination of epidemiological and molecular characteristics of MRSA strains has critical importance because of the difficulties in the treatment and of the nosocomial infections and epidemics they caused. the data obtained would contribute to the preventions in terms of epidemiology.

WOS:000353229500019 PubMed: 26101489 Objective: Early detection of antibiotic susceptibility profile of the isolates has critical importance in terms of immediate beginning of the appropriate treatment and increasing of treatment success, such as meningitis, bacteriemia and sepsis. In the present study, it was aimed to compare the antibiotic susceptibility results of Quicolor (Salubris Inc., Massachusetts, USA) and standard disk diffusion method. Methods: One hundred twenty three isolates were included in this study (80 Enterobacteriaceae, 15 Staphylococci and 28 nonfermentative Gram-negative bacteria). Antibiotic susceptibility in clinical isolates was evaluated using Mueller-Hinton (MH) agar and Quicolor (ES and NF) agar plates. Results: For Enterobacteriaceae, frequency of total concordance, major error, and minor error between the tests were found as 96.8%, 0.8%, and 2.4%, respectively. For Staphylococci, frequency of total concordance, major error, and minor error among the tests were found as 95.7%, 3.5%, and 0.8%, respectively. For non fermentative bacteria, frequency of total concordance, major error, and minor error among the tests were found as 83.9%, 9.6%, and 6.4%, respectively. Conclusions: Quicolor media provided reliable susceptibility results in enteric bacteria and Staphylococci. However, further studies including higher number of nonfermentative bacteria are required to determine whether the chromogenic media are appropriate for this group of bacteria.

WOS:000437112500001 Background - Presence of microorganisms in sterile body sites leads to life-threatening infections. For early and accurate diagnosis of those infections, cultures of the sterile fluids have to be done. These cultures can not always detect the causative agents due to insufficent number or fastidious growing of the probable microorganisms in the material. Objectives - In this study, it was aimed to compare sterile body fluid cultures which had been processed with both conventional culture methods and BACTEC automatized blood culture system retrospectively. Material and Methods - A total of 138 body fluid cultures were compared retrospectively from the laboratory records. Results - Amongst the specimens, 122 cultures were negative. Nine of the rest 16 specimens were positive with both culture methods and seven cultures were positive with BACTEC only. None of the specimens which were negative in BACTEC system revealed positive with the conventional method. BACTEC detected significantly higher number of positivity (P

WOS:000339926700010 PubMed: 24619262 Introduction: Tularemia is a zoonotic disease caused by Francisella tularensis. Here we present an epidemic occurring in Bolu province, located in northwestern Anatolia in Turkey, and some features of the cases. Methodology: The data was provided by the Bolu Provincial Health Directorate. All of the antibody response tests were studied in the National Health Institute (formerly named Refik Saydam Hygiene Department), the reference laboratory of the Ministry of Health of the Turkish Republic. A total of 393 individuals were tested by microagglutination test (MAT) for tularemia between 2006 and 2011. A total of 218 patients whose demographical data were available were included in the study; 83 were accepted as the patient group and 135 were the controls. Of the patients, 31 (37.3%) were male and 52 (62.7%) were female. Results: Fever (p < 0.001), URTI symptoms (p = 0.047), conjunctivitis (p = 0.004), and rash (p = 0.026) were significantly higher in the patient group. A positive association was found between MAT and fever (r = 0.324; p < 0.001), and a negative association was found between MAT and both lymphoadenopathy (r = -0.25; p = 0.013) and chills (r = -0.218; p = 0.035). Higher MAT titers were detected in oropharyngeal tularemia (r = 0.306; p = 0.003). Conclusions: In conclusion, tularemia must be considered in differential diagnosis in patients presenting with fever and LAP in non-endemic regions. Furthermore, water sources and contact with rodents must be investigated.

Background : Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. Objective : In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF between 2006 and 2012 based on data obtained from the Bolu Provincial Directorate of Health (BPDH) were evaluated. Methods : BPDH data were reviewed for the period between 1 January 2006 and 31 July 2012. The locations where the tick had attached to the patient, the site of the tick bite on the patient’s body, the dates of tick bite and removal, and the demographic characteristics of each patient were recorded. BPDH data on the total number of tick bites, patients with confirmed CCHF, and deaths due to CCHF in Bolu Province during the study period were also evaluated. Results : A total of 46 patients with CCHF and 38 patients without CCHF but who had been bitten by ticks were admitted to the BPDH. Of the patients with CCHF, 54.3% were female. The mean age of the patients was 46.88 ± 2.05 years (range, 1–79 years). The mortality rate was 8.82%. Patients were predominantly observed in June and July. When the patients were distributed according to their occupations, the majority was houswife (48.6%), followed by animal husbandry worker (27.0%), farmer (10.8%), health worker (5.4%), and other (8.1%). The symptoms of the patients with CCHF included fatigue (60.9%), fever (60.9%), and myalgia (60.9%). Of those patients with CCHF, 41.3% were determined to have a high fever. Conclusions : The probability of developing CCHF decreased as the duration of tick attachment increased. Moreover, although the clinical presentation is important, it is not diagnostic. Physical examination and laboratory findings become more specific in later stages. Keywords : Black Sea, Crimean-Congo hemorrhagic fever virus

WOS:000334562700031 PubMed: 24772147 Background and Objectives: Autoantibodies are innmunglobulins occurred directly against autoantigens that are known as endogen antigens. Autoinnmune disease is an occasion that the body begins a fight against its own cells and tissues. The antibodies that are created by the body against its own cell nuclei are called as anti-nuclear antibodies (ANA), and one of the methods used for detection and pattern of ANA is indirect immunofluorescence test (IIF). In the present study, it was aimed to determine the rate of ANA positivity and patterns of the positive specimens, and to investigate the relationship between ANA positivity and diseases in patients. Methods: ANA test results of a total of 3127 patients admitted during March 2010 to December 2012 were evaluated retrospectively. ANA test (HEp 20-10, EUROIMMUN, Germany) was used in dilution of 1:100 in IIF test. Results: A total of 494 (15.8%) resulted as ANA positive. ANA positivity rate was significantly higher in female patients than the male ones (p < 0.001). The most frequent ANA patterns were coarse speckled pattern (154 patients, 31.2%), nucleolar pattern (89 patients, 18.0%), fine speckled pattern (57 patients, 11.5%), and speckled pattern (48 patients, 9.7%). ANA positivity was most commonly determined in rheumatoid arthritis (RA) (42 patients, 8.5%), systemic lupus erythematosus (SLE) (29 patients, 5.9%), and rheumatoid vasculitis (RV) (28 patients, 5.7%). The most frequent symptoms or findings were joint pain (127 patients, 26.0%) and anemia (28 patients, 5.7%). ANA positivity rates were found to be significantly higher in patients with RA (p < 0.001), with SLE (p < 0.001), and with Raynaud phenomenon (p=0.001) in comparison to the controls. Amongst the most frequent diseases evaluated, no significant differences were found between the control groups and the groups of RV (p=0.089), multiple sclerosis (p=0.374), and Sjogren syndrome (p=0.311) in terms of ANA positivity rates. Conclusions: The present study is the first study reporting the positivity rate and distribution of ANA in Bolu located in northwestern Turkey. Information about the pattern types and the distribution of the patterns according to the diseases and symptoms contribute in diagnosis of autoimmune diseases. It is observed that clinical diagnosis has been supported significantly by ANA test according to data of our study.

WOS:000334615100001 PubMed: 24669818 Background: Asymmetric dimethylarginine (ADMA), the main endogenous inhibitor of nitric oxide synthase, is considered to be associated with endothelial dysfunction. High ADMA levels have been shown to be related with disorders causing vascular inflammation such as hypertension, hypercholesterolemia, atherosclerosis, chronic heart failure, stroke and sepsis. Cutaneous anthrax (CA) is a serious infectious disease which may cause vasculitis. The aim of the study was to investigate the serum ADMA levels in patients with CA. Methods: A total of 35 serum samples of the patients with CA and 18 control sera were tested for ADMA levels using ADMA ELISA kit (Immunodiagnostik AG, Bensheim, Germany). Results: ADMA levels were found to be significantly higher in the patients group than the controls (p < 0.001). In addition, ADMA levels were found to be positively associated with sedimentation rates (R = 0.413; p = 0.026), and inversely associated with international normalized ratio (INR) levels (R = -0.46; p = 0.011). A cut-off value of 0.475 of ADMA had a sensitivity of 74.3%, specificity of 77.8%, and accuracy of 75.5% in the diagnosis of CA. Conclusion: Although the exact mechanism still remains unclear, ADMA levels could be related to immune activation in CA. In addition, these data might suggest the higher ADMA levels in patients could be due to the perivascular inflammation and vasculitis in CA.

WOS:000330925200011 PubMed: 24289764 The management of infections due to A. baumannii is difficult because of rapidly developing resistance, however, tigecycline, a glycylcyline antimicrobial, is in use for several years. In the present study, it was aimed to determine the susceptibility rates of A. baumannii to tigecycline. A total of 90 A. baumanni isolates were tested using three methods such as disk diffusion, broth microdilution, and E-test. The MIC50 and MIC90 values and the MIC range were found as 2 mu g/ml, 4 mu g/ml, and 0.1-8 mu g/ml by microdilution; and 2 mu g/ml, 6 mu g/ml, and 0.1-12 mu g/ml by E-test, respectively. There were a few major errors as well as the minor rates were all high as between 35.7%-46.7%. The accuracy rates between the methods were low as 53.3% (48/90) between disk diffusion and E-test, 51.1% (46/90) between disk diffusion and microdilution, and 60.0% (54/90) between E-test and microdilution. In the ROC curve analysis, an inhibition zone diameter of susceptibility breakpoint of 21.5 mm had sensitivity between 68.8%-88.9%; specificity between 81.9%-87.9%; and accuracy between 80.0%-83.33%. An analysis based on EUCAST's non-species breakpoints, the MIC tests showed higher accuracy with a rate of 96.7%, however, performance of disk diffusion got worse as lower than 25%. In conclusion, we showed that the reliability of the methods even did not remain as high as the past. Our study presented that none of three methods revealed reliable results in determination of susceptibility of A. baumanni to tigecycline, so the clinical response should be followed up carefully in such cases. (C) 2013 Association of Basic Medical Sciences of FB&H. All rights reserved