Assessment of index value performance of enzyme immunoassay test in predicting the diagnosis of human brucellosis.

INTRODUCTION: Clinical presentation of brucellosis is variable. Therefore, it must be confirmed with laboratory findings. Standard tube agglutination test (STAT) is commonly used for diagnosis of brucellosis. ELISA tests differentiate between IgM and IgG antibodies. However, there are evidences revealing that they do not have sufficient specificity. This study aimed to determine an ELISA optimal index value in the diagnosis of brucellosis. METHODOLOGY: Brucella STAT and ELISA IgM/IgG tests of patients admitted to the hospital with signs and symptoms of brucellosis between January 2017 and December 2019 were evaluated in the Microbiology Laboratory. RESULTS: ELISA IgM and IgG serum median index value was significantly higher in STAT positive (1 ≥ 1:160) group (p < 0.001 for both). By ROC analysis of 117 patients, when the IgM index value was determined to be 2.44, the sensitivity, specificity, positive and negative predictive values were 85.7%, 71.4%, 60%, and 90.9%, respectively, and when the IgG index 7.85 was determined, these values were 85.7%, 53.7%, 36.7%, and 92.3%, respectively was detected. CONCLUSIONS: In this study, it was revealed that Vircell Brucella had a good clinical diagnostic performance for index value of 2.44 for IgM test kit and 7.95 for IgG test kit. If the diagnosis of brucellosis is correctly predicted with index values in Brucella IgM and IgG tests before STAT analysis, they can be used in the process of clinical decision. In addition to the results of Brucella ELISA, reporting index values and determining optimal index values for each laboratory can help the diagnosis of brucellosis.

[Investigation of Intestinal Parasites and Level of Hygiene Knowledge of School Students]. / Ögrencilerde Bagirsak Parazitlerinin ve Hijyen Bilgi Düzeylerinin Arastirilmasi.

OBJECTIVE: In this study, the prevalence of intestinal parasites and its relationship with some hygiene habits and socio-demographic characteristics of students in Yigilca were investigated. METHODS: This study was conducted in three parts. Firstly, the prevalence of parasitic diseases was measured, and questionnaires about the level of knowledge of hygiene were administered. Secondly, control and intervention groups were determined. Lastly, some education and training courses were organized and provided to the intervention group, including parents and children, about the prevention of parasitic diseases and habits of cleaning. RESULTS: In this study, 540 cellophane tapes and 523 stool samples were studied. Among the samples analyzed, 87 (16.1%) with Enterobius vermicularis, 79 (15.1%) with Giardia intestinalis, 73 (13.9%) with various non-pathogenic parasites, 1 (0.19%) with Ascaris lumbricoides, and 1 (0.19%) with Hymenolepis nana were found. G. intestinalis was highly positive among the children who do not wash their hands after defecation. Also, some intestinal parasites were found to be related to the socio-demographic characteristics of families; parental education, family income, and father's profession were found to be associated with the presence of intestinal parasites. After training, the intervention group showed a significant decrease in the number of giardiasis and enterobiasis cases. CONCLUSION: Education on hygiene will prevent parasitic diseases from an early age.

[Investigation of the effects of probiotic bacteria on bacterial translocation that developed during diagnostic laparoscopy: an experimental study]. / Tanisal Amaçla Uygulanan Laparoskopi Sirasinda Olusan Bakteriyel Translokasyona Probiyotik Bakterilerin Etkilerinin Arastirilmasi: Deneysel Bir Çalisma.

Probiotics which are non-pathogenic live microorganisms ingested along with food or as dietary supplements, are thought to be beneficial to the host by supporting the microbial balance in digestive system. Various studies suggest that the effects of probiotics on the intestinal mucosa and immunity are protective against bacterial translocation. We aimed to investigate bacterial translocation related to the amount of CO2 insufflation given during laparoscopy and the effect of probiotic bacteria in an experimental peritonitis model. In this study 60 Wistar rats were used in six groups consisting of 10 rats. Group 1, 3 and 5 consisted of the rats that were fed without probiotics, while the rats in Group 2, 4, and 6 were fed with water containing 5 x 108 cfu/ml probiotic bacteria complex (Bifidobacterium lactis, Lactobacillus bulgaricus, Streptococcus thermophilus) for 15 days. To generate experimental peritonitis, 2 x 107 cfu/ml Escherichia coli ATCC 25922 was inoculated intraperitoneally to all of the rats. Thereafter, laparoscopy was applied in all groups. Application in Group 1 and Group 2 was without CO2; Group 3 and Group 4 with 14 mmHg CO2 insufflation, and Group 5 and Group 6 with 20 mmHg CO2 insufflation. Blood samples were taken in 2nd, 4th, and 6th hours. Mesenteric lymph node, liver and spleen samples were taken at 6th hour when the rats were sacrificed and then these were evaluated microbiologically with qualitative and quantitative methods. Bacterial translocation and bacteremia were found in the rats that were undergone experimental peritonitis during laparoscopy. All positive tissue and blood cultures yielded E.coli. The highest level of bacterial translocation was found to be in mesenteric lymph nodes (in 3/10, 6/10 and 10/10 in groups 1, 3 and 5 fed without probiotics, respectively; in 2/10, 3/10 and 4/10 in groups 2, 4 and 6 fed with probiotics, respectively). The bacterial translocation rates were found to be related to the increased CO2 insufflation. It was found that probiotic bacteria were more effective for decreasing bacterial translocation rates and bacteremia in the groups that were given high CO2 pressure during laparoscopy. It was also found that these results were correlated with bacterial translocation per gram of tissue. As an example, the quantitative bacterial growth values detected in mesenteric lymph node were 5.4 ± 2.9 x 103, 10.6 ± 3.3 x 103 and 21.5 ± 12.4 x 103 cfu/g in groups 1, 3 and 5, fed without probiotics, respectively; and 2.0 ± 1.3 x 103, 3.8 ± 1.9 x 103 and 9.0 ± 3.1 x 103 cfu/g in groups 2, 4 and 6, fed with probiotics, respectively. Our data emphasized that probiotic bacteria may be used as prophylactic agents for the prevention of bacterial translocation during laparoscopy, however comprehensive and clinical studies are needed to support these experimental results.