Evaluation of factors associated with response to hepatitis B vaccination in patients with inflammatory bowel disease.

It is recommended to investigate the serology of hepatitis B virus (HBV) and vaccinate seronegative patients at the time of diagnosis in inflammatory bowel diseases (IBD). This study aimed to investigate the efficacy of HBV vaccine and factors affecting the response.In this retrospective, observational study, HBV-seronegative IBD patients were administered 3 doses (at months 0, 1, and 6) recombinant 20  µg HbsAg. Patients' demographics, IBD attributes, and treatment methods were investigated as the factors with potential impacts on vaccination outcomes.One hundred twenty-five patients with IBD were evaluated. The number of patients with Anti-HBs >10  IU/L was 71 (56.8%), and the number of patients with anti-HBs >100  IU/L was 50 (40%). Age, disease activity, Crohn disease subtype, and immunosuppressive treatment (IST) were found to have significant effects on immune response (P = 0.011, P < 0.001, P = 0.003, and P < 0.001, respectively). With multivariate analysis, age < 45 years (OR 3.1, 95% CI 1.2-8.3, P = 0.020), vaccination during remission (OR 5.6, 95% CI 2.3-14, P < 0.001), and non-IST (OR 11.1, 95% CI 2.9-43.2, P = 0.001) had favorable effects on the occurrence of adequate vaccine response.The likelihood of achieving adequate immune response with standard HBV vaccination protocol in IBD is low. Selecting vaccination protocols with more potent immunogenicity is a better approach to achieve effective vaccine response in patients with multiple unfavorable factors.

Comparison of Helicobacter pylori antibody detection in stool with other diagnostic tests for infection.

For detection of Helicobacter pylori, bacterial culture and histopathological examination are invasive in nature, whereas the fast urease test and urea breath test are non-invasive and indirect methods of detection. Stool antibody tests and polymerase chain reaction (PCR) to detect genomic DNA are serological methods, which are preferred to invasive examinations. Our aim was to assess diagnostic specifity and sensitivity of stool antibody tests, with histopathological examination as the golden standard and to compare results with fast urease test findings. Biopsy samples of patients in the study were evaluated as examples of invasive methods, and also stool antibody screening were made (HpSA). When urease and HpSA test results were compared with histopathological results, sensitivity and specificity of urease test were 62.2% and 100%, respectively, and 68.9% and 100% for the HpSA test. General accuracy was 80% and 81%, respectively , positive predictive value 100% with each and negative predictive values 66.1% and 67.2% . The differences were not statistically significant, and the confidence intervals were approximately in the same range. Thus results obtained with biopsy urease and HpSA tests were generally similar to those obtained by histopathological examination. A review of national and international literature showed similar findings.

Prevalence and antimicrobial susceptibility of Escherichia coli in outpatient urinary isolates in Izmir, Turkey.

BACKGROUND: Knowledge of antimicrobial resistance pattern in Escherichia coli, the predominant pathogen associated with urinary tract infection (UTI), is important as a guide in selecting empirical antimicrobial therapy. The aim of this study was to determine the antibiotic susceptibility patterns of E. coli strains isolated from adult outpatients with UTI, in Izmir, Turkey. MATERIAL/METHODS: This study was performed with isolates from outpatients with UTI, collected from 5 university and tertiary-care hospitals in Izmir, Turkey. Isolates were analyzed by standard methods and antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. RESULTS: A total of 4,534 E. coli strains (3,449 females and 1,085 males) were examined. Antibiotic resistance rates of the isolates for female and male, respectively: Ampicillin (61.8%, 78.7%), amoxicillin-clavulanic acid (36.6%, 59.1%), cefuroxime (22.5%, 41.3%), cefotaxime (18.2%, 35.8%), piperacillin-tazobactam (11.6%, 31.2%), amikacin (8.3%, 13.9%), gentamicin (24.9%, 40%), trimethoprim-sulfamethoxazole (42.1%, 57.3%), and ciprofloxacin/norfloxacin (42.1%, 63.3%). Extended spectrum beta-lactamase rate was found to be 18.3% and 26.1% for females and males, respectively. The isolates were significantly more resistant to all antibiotics in men than in females in this study (p<0.001). CONCLUSIONS: The most important finding of our study is that a considerable proportion of the studied E. coli isolates were resistant to most antibiotics except amikacin. These data provide useful information for clinicians in determining the appropriate empirical antimicrobial regimen, and help authorities to formulate antibiotic prescription policies.

Evaluation of real-time PCR method for rapid diagnosis of brucellosis with different clinical manifestations.

In this study, we tested the advantages of TaqMan real time PCR technique and compare it to conventional methods using serum samples from patients with different clinical forms of brucellosis. A total of 50 patients were included in the study. Blood culture using BACTEC 9240 system, Standard Wright's tube agglutination, and real time PCR methods were used. Control blood samples from 30 people with no history of brucellosis or exposure to Brucella spp. were examined too. Serological assay was positive for 49 patients (98%). Forty-four (88%) of the 50 patients had a positive PCR result, whereas Brucella spp were isolated from blood cultures of 18 patients (36%). STA test was all positive for focal brucellosis. Real time PCR test was positive in 9 patients with focal disease (90%), whereas blood culture was positive only in 4 patients (40%). The sensitivity, specificity, positive and negative predictive values of the real time PCR method were calculated as 88%, 100%, 100%, and 83%, respectively. Our results suggest that the high sensitivity and specificity of real time PCR method make it a useful tool for diagnosis of brucellosis with different clinical manifestations.

A case of Acremonium strictum peritonitis.

During the past two decades opportunistic fungal infections have emerged as important causes of morbidity and mortality in patients with severe underlying illnesses. A few cases of Acremonium spp. infections have been described in immunocompromised patients, but they have on occasion been reported as the cause invasive disease in immunocompetent individuals. Peritonitis is a common clinical problem that occurs in patients with end-stage renal disease treated by continuous ambulatory peritoneal dialysis (CAPD). Yeasts, or rarely molds, may also cause peritonitis in patients on CAPD and we present here a case caused by Acremonium strictum.