Evaluation of Toxoplasma, Rubella, and Cytomegalovirus serological results in women of childbearing age.

OBJECTIVE This study aimed to determine the rates of IgG and IgM antibodies against cytomegalovirus, rubella, and Toxoplasma gondii (all of which may cause congenital infections) in women of childbearing age who were admitted to Bolu Abant Izzet Baysal University Training and Research Hospital. METHODS Between January 2015 and December 2017, Toxoplasma gondii, rubella, and cytomegalovirus IgM and IgG antibody levels were studied using the ELISA method (Architect i2000SR, Abbott, Germany) in patients aged 15 to 45 who attended the obstetrics and gynecology outpatient clinics. Toxoplasma gondii and cytomegalovirus IgG avidity levels were analyzed retrospectively. RESULTS A total of 13.470 tests were conducted in the laboratory. Seropositivity percentages of IgM antibodies were found to be 1.3%, 0.5%, and 1.6% for Toxoplasma (n = 3607), rubella (n = 3931), and cytomegalovirus (n = 3795), respectively. The seropositivity percentages of IgG antibodies were 22%, 94.2%, and 98.2% for Toxoplasma (n = 702), rubella (n = 693), and cytomegalovirus (n = 679), respectively. Primary infection (acute, recently acquired) was found in 7 (35%) patients with low Toxoplasma IgG avidity. One (3%) patient with low cytomegalovirus IgG avidity had a primary infection. CONCLUSION Toxoplasma gondii seronegativity was found to be high in the region. Therefore, screening women of childbearing age may be important for the prevention of congenital infections caused by Toxoplasma gondii.

Evaluation of Toxoplasma, Rubella, and Cytomegalovirus serological results in women of childbearing age

SUMMARY OBJECTIVE This study aimed to determine the rates of IgG and IgM antibodies against cytomegalovirus, rubella, and Toxoplasma gondii (all of which may cause congenital infections) in women of childbearing age who were admitted to Bolu Abant İzzet Baysal University Training and Research Hospital. METHODS Between January 2015 and December 2017, Toxoplasma gondii, rubella, and cytomegalovirus IgM and IgG antibody levels were studied using the ELISA method (Architect i2000SR, Abbott, Germany) in patients aged 15 to 45 who attended the obstetrics and gynecology outpatient clinics. Toxoplasma gondii and cytomegalovirus IgG avidity levels were analyzed retrospectively. RESULTS A total of 13.470 tests were conducted in the laboratory. Seropositivity percentages of IgM antibodies were found to be 1.3%, 0.5%, and 1.6% for Toxoplasma (n = 3607), rubella (n = 3931), and cytomegalovirus (n = 3795), respectively. The seropositivity percentages of IgG antibodies were 22%, 94.2%, and 98.2% for Toxoplasma (n = 702), rubella (n = 693), and cytomegalovirus (n = 679), respectively. Primary infection (acute, recently acquired) was found in 7 (35%) patients with low Toxoplasma IgG avidity. One (3%) patient with low cytomegalovirus IgG avidity had a primary infection. CONCLUSION Toxoplasma gondii seronegativity was found to be high in the region. Therefore, screening women of childbearing age may be important for the prevention of congenital infections caused by Toxoplasma gondii.

RESUMO OBJETIVO O objetivo deste estudo foi determinar as taxas de anticorpos IgG e IgM contra citomegalovírus, rubéola e Toxoplasma gondii (todos os quais podem causar infecções congênitas) em mulheres em idade fértil que foram admitidas no Hospital de Pesquisa e Treinamento da Universidade Bolu Abant İzzet Baysal. MÉTODOS Entre janeiro de 2015 e dezembro de 2017, os níveis de anticorpos IgG e IgM para Toxoplasma gondii, rubéola e citomegalovírus foram estudados usando o método Elisa (Architect i2000SR, Abbott, Alemanha) em pacientes de 15 a 45 anos que compareceram a ambulatórios de obstetrícia e ginecologia. Os níveis de avidez de IgG para Toxoplasma gondii e citomegalovírus foram analisados retrospectivamente. RESULTADOS Um total de 13.470 testes foram realizados em laboratório. As porcentagens de soropositividade dos anticorpos IgM foram de 1,3%, 0,5% e 1,6% para Toxoplasma (n=3.607), rubéola (n=3.931) e citomegalovírus (n=3.795), respectivamente. As porcentagens de soropositividade dos anticorpos IgG foram 22%, 94,2% e 98,2% para Toxoplasma (n=702), rubéola (n=693) e citomegalovírus (n=679), respectivamente. Infecção primária (aguda, adquirida recentemente) foi encontrada em sete (35%) pacientes com baixa avidez para Toxoplasma IgG. Um (3%) paciente com baixa avidez para citomegalovírus IgG teve uma infecção primária. CONCLUSÃO A soronegatividade do Toxoplasma gondii foi alta na região. Portanto, testar mulheres em idade fértil pode ser importante para a prevenção de infecções congênitas causadas pelo Toxoplasma gondii.

Real-time PCR Detection of the Most Common Bacteria and Viruses Causing Meningitis.

BACKGROUND: Central nervous system (CNS) infections require prompt diagnosis, as the clinical condition progresses rapidly and may lead to severe permanent sequelae or death. The causative agents include viruses, bacteria, fungi, and parasites. In this study, samples with the diagnosis of CNS infection based on cerebrospinal fluid (CSF) sent to us from other hospitals/labs, were studied by multiplex real-time Polymerase Chain Reaction (PCR) method. The purpose of this study is to demonstrate, retrospectively, the most common bacteria and viruses causing meningitis and seasonal distribution of these agents using the multiplex real-time PCR method in CSF samples. METHODS: This study retrospectively evaluated the results of 470 CSF specimens that had been sent to the Molecular Unit of our hospital with a pre-diagnosis of CNS infection and had been tested with the PCR method between January 2014 and December 2015. Specimens were tested using multiplex real-time PCR assay for Adenovirus (AdV), Cytomegalovirus (CMV), Enteroviruses (EV) (Polioviruses, Coxackieviruses, Echoviruses, and other enteroviruses), Epstein- Barr virus (EBV), Herpes simplex virus 1 and 2, Human Herpes virus 6 and 7, Varicella-zoster virus (VZV), Human Parechoviruses and Parvovirus B19, Hemophilus influenzae, Streptococcus pneumoniae or Neisseria meningitidis. (FTD NEURO9 and FTD Bacterial meningitis, multiplex real-time PCR Kit). RESULTS: A bacterial or viral agent was identified in 98 (21%) of the 470 CSF samples. Of the patients, 85% were children and 15% were adults. Of the 98 positive samples, 22 (22.5%) patients were 15 years or older, and the remaining 76 (77.5%) were younger than 15 years. While Enterovirus (25%) was the most frequently identified agent, Adenovirus ranked second (22%) and Streptococcus pneumoniae ranked third (15%) in total. Positivity was highest in the 0 - 5-year age range. Bacteria were detected with the PCR method in 22 patients: S. pneumonia in 14, and N. meningitidis in 8. In cultures, S. pneumonia grew only in 7 and N. meningitidis in one. EV and AdV were seen in the summer months. The two coexisted in 3 (3%) patients. CONCLUSIONS: Early diagnosis and treatment of meningitis are very important for reducing its mortality and morbidity. In patients with suspected meningitis, early detection of the responsible agents may be possible with molecular methods, such as PCR. Significant economic benefits may be obtained by preventing unnecessary antibiotic use and hospitalizations through the early detection of the microbial agents.

New therapy option for treatment of methicillin-resistant Staphylococcus aureus keratitis: tigecycline.

PURPOSE: The aim of the present study was to evaluate the effectiveness of topically applied tigecycline for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in a rabbit model. METHODS: Experimental bacterial keratitis was induced in rabbits by a corneal intrastromal injection of 100 colony-forming units (CFUs) of MRSA bacteria. Sixteen hours after the injection, 28 rabbits were randomly divided into 4 treatment groups of 7 rabbits each. In each group, the rabbits' eyes were treated topically with 19 doses of topical tigecycline (10 or 50 mg/mL), vancomycin (50 mg/mL), or isotonic saline. Slit lamp examinations were performed before and after the inoculation by two observers masked to the study for the determination of clinical severity. Corneas were harvested for bacterial quantitation and histopathologic examination. RESULTS: No significant differences were observed in the clinical scores between pretreatment and posttreatment in the 4 groups (P>0.05). The mean difference between the pretreatment and posttreatment clinical scores from the 4 treatment groups was also not significant (P>0.05). All treatment groups had significantly lower CFUs compared with the control group. There were no significant differences in the bacterial load among the treatment groups. The minimum inhibitory concentration (MIC) for tigecycline was 0.12 µg/mL, whereas the MIC for vancomycin was 2.2 µg/mL. The tigecycline 10 mg/mL group had the lowest mean epithelial erosion values among the treatment groups. CONCLUSIONS: Topical tigecycline significantly reduced the bacterial load in infected rabbit corneas and may be as effective as vancomycin for the topical treatment of MRSA keratitis.

Comparison of the GenoType(®) MTBC Molecular Genetic Assay with culture methods in the diagnosis of tuberculosis.

INTRODUCTION: Clinical samples from 433 patients pre-diagnosed with tuberculosis in Konya, Turkey, were investigated prospectively to compare the GenoType(®) MTBC test (GenoType(®) MTBC) with conventional "gold standard" culture methods. MATERIAL AND METHODS: Lowenstein Jensen (LJ) and Mycobacteria Growth Indicator Tube (MGIT)-960 culture methods and GenoType(®) MTBC were performed together. RESULTS: Mycobacterium tuberculosis (M. tuberculosis) detection rates were 16.2% by culture methods, 15.4% by GenoType(®) MTBC, and 6% by acid-fast bacilli microscopy. The LJ or MGIT-960 with GenoType(®) MTBC detected M. tuberculosis in 12 samples each that were negative according to the other culture method alone. Among 70 M. tuberculosis-positive samples, detection rates were 37% (26/70) by microscopy and 82.8% (58/70) by LJ and MGIT-960, but 95.7% (67/70) by GenoType(®) MTBC. CONCLUSIONS: GenoType(®) MTBC may be used as a beneficial adjunct test to culture methods for the detection of M. tuberculosis.

Detection of the frequency of PER-1 type extended-spectrum ß-lactamase-producing Acinetobacter baumannii clinical isolates in Turkey: a multicenter study.

BACKGROUND/AIM: ß-Lactamases are an important resistance mechanism in Acinetobacter baumannii. Pseudomonas extended-resistance (PER-1) type ß-lactamase-producing strains have been reported from various geographic locations; however, PER-1 type ß-lactamases from Turkish hospitals have not been investigated extensively. The aim of this study was to determine the prevalence of PER-1 type ß-lactamases in A. baumannii isolates in various regions of Turkey. MATERIALS AND METHODS: A total of 763 clinical A. baumannii isolates were collected from 9 university hospitals and 2 state hospitals between 2008 and 2011. Molecular amplification of the OXA-51 gene from the A. baumannii genome was performed in order to verify identification of the species. Real-time polymerase chain reaction was used to detect blaPER-1 genes. RESULTS: PER-1 was detected in 24.6% of the isolates. The annual frequencies of the PER-1 enzyme were detected as 52.2%, 35.9%, and 8.3% in 2008, 2009, and 2010, respectively. PER-1 prevalence decreased gradually over time. The differences observed in PER-1 prevalence among the regions of Turkey were statistically significant (chi-square test; P < 0.001). CONCLUSION: These data demonstrate that the frequency of detection of PER-1 type ß-lactamases in A. baumannii species has decreased in Turkey. However, the increased carbapenem resistance, together with multidrug resistance, has created a worrisome situation regarding this pathogen.

[Distribution of blaOXA genes in Acinetobacter baumannii strains: a multicenter study]. / Acinetobacter baumannii Izolatlarinda blaOXA Genlerinin Dagilimi: Çok Merkezli Bir Çalisma.

Acinetobacter baumannii is the most important agent of nosocomial infections within the Acinetobacter genus. This gram-negative coccobacillus is intrinsically resistant to many antibiotics used in antimicrobial therapy, and capable of developing resistance including carbapenems. The objective of this study was to develop a multiplex real time polymerase chain reaction (qPCR) kit for OXA subgroups in A.baumannii, and to investigate the distribution of OXA subgroups in A.baumannii strains isolated from geographically different regions of Turkey. A total of 834 A.baumannii clinical isolates collected from different state and university medical centers in 13 provinces (Afyonkarahisar, Ankara, Bolu, Elazig, Erzurum, Isparta, Istanbul, Kahramanmaras, Konya, Sakarya, Van) between 2008-2011, were included in the study. The isolates were identified by conventional methods and automated systems [Vitek2 (bioMerieux, ABD) and Phoenix (BD Diagnostic, MD)]. The susceptibility profiles of the isolates were studied with automated systems and standard disc diffusion method. All samples were subjected to qPCR to detect blaOXA-51-like, blaOXA-23-like and blaOXA-58-like genes. A conventional PCR method was also used to detect blaOXA-24-like gene. The resistance rates observed during the study period were as follows: 96.8% for amoxicillin-clavulanate, 86.8% for ciprofloxacin, 74.7% for gentamicin, 71.7% for amikacin, 73.5% for cefaperozone-sulbactam, 72.1% for imipenem and 73% for meropenem. Six hundred and two (72.2 %) isolates were resistant to both imipenem and meropenem. Colistin was found to be the most effective antibiotic against A.baumannii isolates with 100% susceptibility rate. All isolates were positive for blaOXA-51-like, however blaOXA-24-like gene could not be demonstrated in any isolate. Total positivity rates of blaOXA-23-like and blaOXA-58-like genes were found as 53.7% and 12.5%, respectively, while these rates were 74.4% and 17.3% in carbapenem-resistant isolates, respectively. Twenty-five isolates were positive for both blaOXA-23-like and blaOXA-58-like genes. All of the carbapenem-resistant isolates have OXA type genes with the exception of blaOXA-24-like gene. The positivity rates for blaOXA-23-like and blaOXA-58-like genes varied for each center. In addition, there was a decrease in the frequency of blaOXA-58-like gene, however both blaOXA-23-like gene and carbapenem resistance rates increased during the study period. In conclusion, high rates of resistance to carbapenems were also remarkable but A.baumannii strains keep on sensitivity to colistin. Both blaOXA-23-like and blaOXA-58-like genes were shown to be widespread in carbapenem-resistant A.baumannii clinical isolates. However, blaOXA-23-like gene positive strains were increased throughout the study. Currently, multiplex qPCR is the best way for rapid diagnosis of resistant bacteria for prevention of hospital-acquired infections. The multiplex qPCR kit developed in this study could be useful for rapid diagnosis and identify the frequencies of blaOXA-23-like, blaOXA-51-like and blaOXA-58-like genes in carbapenem-resistant A.baumannii clinical isolates.

Prevalence of Cryptosporidium spp. in asymptomatic food workers.

OBJECTIVE: Cryptosporidium spp. is obligatory intracellular parasite and causes intestinal infection. In intestine infections in the form of sporadic and epidemics, food and accordingly workers in food sector may play a role as the source of infection. In this study, it is aimed to reveal the existence of asymptomatic cryptosporidiosis. METHODS: In the study, stool samples of 393 workers -employed at various branches of food sector in the region of Van- are used. In order to detect Cryptosporidium spp. oocysts, Modified Ziehl Neelsen (MZN) Staining was used. RESULTS: In this study, asymptomatic cryptosporidiosis has been detected in 5 (1.27%) of 393 workers. CONCLUSION: Epidemiological findings indicate that food workers can be source of cryptosporidiosis outbreak. Thus, searching for the existence of asymptomatic cryptosporidiosis food workers -which epidemiologically has potential significance- and taking the required measures in case of its determination are significant in respect of public health.

Comparison of a newly developed automated and quantitative hepatitis C virus (HCV) core antigen test with the HCV RNA assay for clinical usefulness in confirming anti-HCV results.

Hepatitis C virus (HCV) is a global health care problem. Diagnosis of HCV infection is mainly based on the detection of anti-HCV antibodies as a screening test with serum samples. Recombinant immunoblot assays are used as supplemental tests and for the final detection and quantification of HCV RNA in confirmatory tests. In this study, we aimed to compare the HCV core antigen test with the HCV RNA assay for confirming anti-HCV results to determine whether the HCV core antigen test may be used as an alternative confirmatory test to the HCV RNA test and to assess the diagnostic values of the total HCV core antigen test by determining the diagnostic specificity and sensitivity rates compared with the HCV RNA test. Sera from a total of 212 treatment-naive patients were analyzed for anti-HCV and HCV core antigen both with the Abbott Architect test and with the molecular HCV RNA assay consisting of a reverse transcription-PCR method as a confirmatory test. The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 96.3%, 100%, 100%, and 89.7%, respectively. The levels of HCV core antigen showed a good correlation with those from the HCV RNA quantification (r = 0.907). In conclusion, the Architect HCV antigen assay is highly specific, sensitive, reliable, easy to perform, reproducible, cost-effective, and applicable as a screening, supplemental, and preconfirmatory test for anti-HCV assays used in laboratory procedures for the diagnosis of hepatitis C virus infection.

[Isolation rate of Mycobacterium tuberculosis complex from patients with suspected tuberculosis and identification of the strains with BACTEC™ NAP and immunochromatographic TB Ag MPT64 Rapid™ Tests]. / Tüberküloz Süpheli Hastalardan Mycobacterium tuberculosis Kompleks Izolasyon Orani ve Suslarin BACTEC™ NAP ve Immünokromatografik TB Ag MPT64 Rapid™ Testleri ile Tanimlanmasi

Tuberculosis (TB) which is still one of the important infectious diseases in the world as well as Turkey, results in high morbidity and mortality. Clinical mycobacteriology laboratories have crucial roles in the identification, typing and susceptibility testing of Mycobacterium tuberculosis. The aims of this study were the investigation of the isolation rate of M.tuberculosis complex (MTC) from the clinical specimens of TB-suspected patients and to compare identification of mycobacteria isolated from solid and/or liquid media by using BACTEC NAP and immunochromatographic TB Ag MPT64 rapid test. A total of 1670 patients who were admitted to outpatients clinics of our hospital and prediagnosed as TB, have been included in the study. All the patients were anti-HIV seronegative. NALC-NaOH method were used for decontamination/ homogenization, and preparations from samples were stained with Erlich-Ziehl-Neelsen method to detect acid-resistant bacilli (ARB) in direct microscopy. All of the samples were inoculated into BACTEC™ MGIT-960 (Becton Dickinson, USA) and Löwenstein-Jensen (LJ) media for cultivation and incubated at 37°C for 6-8 weeks. Mycobacteria that were grown in the media have been identified by BACTEC™ NAP (Becton Dickinson, USA) and TB Ag MPT64 rapid test (SD Bioline Ag MPT64 Rapid™; Standard Diagnostics, Korea). The culture positivity in the samples of TB-suspected patients was found to be 3.7% (63/1670) with LJ and/or MGIT-960 methods, whereas ARB positivity rate was 1.6% (28/1670). Fifty-three (84%) out of culture positive 63 samples have been identified as MTC by BACTEC NAP test, while 61 (97%) were found as MTC by TB MPT64 test. Considering BACTEC NAP test as the reference method, TB MPT64 test identified all the MTC strains correctly (sensitivity: 100%), however the false positivity rate was estimated as 12.7% (specificity: 87%). Of 53 MTC positive samples, 36 were sputum, four were bronchoalveolar lavage, four were urine, three were gastric fluid, three were pleural fluid, and one of each were abscess, peritoneal fluid and cerebrospinal fluid samples. ARB positivity rate was detected as 41.5% (22/53) among MTC culture positive samples. Of the patients who were infected with MTC, 72% (38/53) were male and 98% (52/53) were adults (age range: 20-85 years). Our data indicating 3.1% (53/1670) isolation rate of MTC from TB-suspected patients in our region were in concordance with the other results reported from Turkey. In conclusion, immunochromatographic TB Ag MPT64 test which seemed to be useful for the rapid identification of mycobacteria grown on solid and/or liquid, was practical to perform and had high sensitivity, however further larger-scaled studies are needed to support our data in our country.

[Prevalence of intestinal parasites among workers in food sector in Van region]. / Van yöresinde gida sektörü çalisanlarinda bagirsak parazitlerinin yayginligi

Stool and cellophane tape specimens were taken for parasitological examination from 739 people who work in food sector and applied to the public health lab of the Van Health Administration for porter examination. Parasites were determined at 131 people (17.71%) of 739 worker whom samples were investigated. Ninety-five people had one, 30 people had two, 5 people had three and one person had four parasite species. Parasites determined in the study were 19.08% helminthes and 80.91% protozoon. In this study, 1.21% Ascaris lumbricoides, 0.81% Enterobius vermicularis, 0.67% Hymenolepis nana, 0.40% Trichuris trichiura, 0.27% Taenia saginata, 4.87% Blastocystis hominis, 3.24% Entamoeba coli, 2.84% Giardia intestinalis, 2.02% Iodamoeba bütschlii, 0.67% Endolimax nana, 0.27% Entamoeba histolytica/Entamoeba dispar, 0.27% Chilomastix mesnili, 0.13% Entamoeba hartmanni were found.