Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C infection in Western Turkey.

OBJECTIVE: The primary aim of this study was to determine the recent distribution of various genotypes of hepatitis C virus (HCV) in patients with chronic HCV infection in Western Turkey. Additional objectives were to determine whether there are any associations of genotype with gender and age, and to determine the nucleotide similarities and risk factors of non-1 HCV genotypes. METHODS: Serum samples from 345 patients (176 male, 169 female; mean age 53.3+/-12.7 years, range 10-81 years) with chronic HCV infection were analyzed in this study. Viral genotypes were determined by a restriction fragment length polymorphism (RFLP)-based in-house assay. To confirm genotypes for the samples with band patterns other than genotype 1, the 5' UTR was amplified and sequenced. RESULTS: Genotype 1 was observed in 335 of the 345 patients (97.1%). Of these, 34 patients showed infection with subtype 1a (9.9%) and 301 with subtype 1b (87.2%). Genotypes 2, 3, and 4 were determined in 0.9%, 1.4%, and 0.6% of the patients, respectively. Patients infected with type 1 were significantly older than patients infected with non-1 genotypes; however no significant differences were recorded in gender distribution. CONCLUSIONS: Genotypes other than genotype 1 are quite rare; these are possibly acquired in other countries. Turkish patients with chronic hepatitis C still represent a rather homogenous group with genotypic diversity encountered rarely.

Activities of Linezolid against nontuberculous mycobacteria.

The activity of linezolid (Pfizer, USA) was tested by broth microdilution against 53 clinical isolates of non-tuberculous mycobacteria (NTM), including the common disease producing species Mycobacterium avium, M. intracellulare, M. fortuitum, M. chelonae and M. abscessus, obtained from western Turkey. The isolates of M. abscessus and M. intracellulare were the least susceptible, M. mucogenicum, M. gordonae and M. avium were the most susceptible to linezolid of the common species of NTM. Linezolid showed a variable sensitivity in all strains; therefore, each species and strain must be individually evaluated, and it is always advisable to perform in vitro sensitivity tests before using the drug for human therapy.

[Genotyping of rifampin-resistant Mycobacterium tuberculosis isolates by mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) analysis]. / Rifampisine dirençli Mycobacterium tuberculosis izolatlarinin MIRU-VNTR (mycobacterial interspersed repetitive unit-variable number tandem repeat) yöntemiyle genotiplendirmesi.

Molecular typing methods have greatly enhanced our understanding on epidemiology of tuberculosis and allowed us to identify outbreaks and intertransmission within populations. Recently, a set of 12 variable-number tandem repeat (VNTR), designated mycobacterial interspersed repetitive units (MIRU), has been described as being useful for the typing of M. tuberculosis. In this study, 26 rifampin (RIF) resistant M. tuberculosis isolates with known IS6110-RFLP patterns obtained from 26 different patients in Aegean Region were typed by MIRU-VNTR and the data were compared with IS6110-RFLP results. The results showed that in most isolates the clustering on the basis of IS6110 RFLP typing and that on the basis of MIRU-VNTR typing were in agreement. It was also determined that the loci including MIRU 16, MIRU 40, MIRU 26, MIRU 10, MIRU 04 and MIRU 31, respectively, have the highest allelic diversities and discriminatory power. In conclusion, since the discrimination level of conventional MIRU-VNTR including 12 loci might be variable, by the use of additional loci which present high degree of allelic differentiation, this method would be reliable for the epidemiologic studies.

Evaluation of the Genotype MTBDR assay for rapid detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis isolates.

A novel PCR-based reverse hybridization method Genotype MTBDR assay (Hain Lifescience GmbH, Nehren, Germany) was evaluated for rapid detection of rifampin (RIF) and isoniazid (INH) resistance in Turkish Mycobacterium tuberculosis isolates. The Genotype MTBDR assay is designed to detect mutations within the 81-bp hotspot region of rpoB and mutations at katG codon 315. A total of 41 RIF-resistant M. tuberculosis isolates with rpoB mutations that were previously tested by the INNO-LiPA Rif.TB kit and also characterized by DNA sequencing were included in the study. Thirty-seven of these isolates were also resistant to INH. RIF resistance was correctly identified in 39 of 41 isolates (95.1%) with the Genotype MTBDR assay probes specific for these mutations. One isolate with a Gln-490-His mutation and another one with a CGG insertion between codons 514 and 515 were identified as RIF sensitive by the Genotype MTBDR assay. While the INNO-LiPA Rif.TB kit was able to determine the CGG insertion between codons 514 and 515, the Gln-490-His mutation outside the 81-bp hotspot region was not detected by the INNO-LiPA Rif.TB kit. These isolates had MICs of >or=32 microg/ml for RIF. The Genotype MTBDR assay also correctly identified 27 of 37 INH-resistant isolates (73%) with mutations in katG codon 315. In conclusion, the Genotype MTBDR assay may be useful for the rapid diagnosis of the most common mutations found in multidrug-resistant M. tuberculosis strains. However, the test results should always be confirmed with phenotypic methods.