The Prevalence of Hepatitis B and C Among Prisoners in Kahramanmaras, Turkey.

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most important health issues in Turkey. Human immunodeficiency virus (HIV) infections are less frequently observed in the country. The individuals who had blood transfusions, patients undergoing hemodialysis, and intravenous drug addicted individuals, people who had tattoos/piercings, communal living environments, contamination of a family member, and prisoners are the main risk groups. OBJECTIVES: The current study aimed to discuss the prevalence and the genotypes of hepatitis and HIV infections among a specific group, namely individuals incarcerated in prisons. PATIENTS AND METHODS: Two-hundred and sixty-six prisoners sentenced for crimes such as robbery, sexual assault, assault substance abuse or selling drugs in the Kahramanmaras closed prison were recruited for the study. Demographic data and the presence of hepatitis B, hepatitis C and HIV were investigated in the study subjects. RESULTS: Out of the 266 cases included in the study, 89.5% were male, 10.5% were female and the mean age was 31.21 ± 8.99 years. Risk factors were detected in 27.4% of the subjects. Out of the 73 subjects, among whom the risk factors were detected, 20.3% had intravenous substance use, 3.8% had a history of operation/transfusion, 1.9% had a history of indentation and 1.5% had unprotected sexual contact. The rate of hepatitis B surface antigen (HBsAg) positivity was 2.6%, the ratio of anti-HBs positive subjects was 35.0% and immunity was achieved with vaccination in 43% of the subjects. Anti-HCV was positive in 17.7% of the prisoners and the genotype 3 and genotype 1 were 68.1% (n = 32) and 2.1% (n = 1), respectively. CONCLUSIONS: Continued substance abuse among most of the drug addicted individuals in prisons, common use of injection materials, tattoos and other circumstances that cause blood contact increase the risk of blood-borne infections.

Distribution and predominance of genotype 3 in hepatitis C virus carriers in the province of kahramanmaras, Turkey.

BACKGROUND: The hepatitis C virus (HCV) has six major genotypes and more than 100 subtypes, and the determination of the responsible genotype, collection of epidemiological data, tailoring antiviral therapy, and prediction of prognosis have an important place in disease management. OBJECTIVES: The aim of the present study was to determine the distribution of HCV genotypes across geographic regions and compare these data with those obtained from other geographic locations. PATIENTS AND METHODS: The HCV genotypes were identified in HCV RNA positive blood samples, obtained from different centers. The HCV genotype was determined using molecular methods [Real-Time Polymerase Chain Reaction (RT-PCR)] in 313 patients, who were found to be positive for HCV RNA. The presence of HCV RNA was investigated using the RT-PCR method in serum samples delivered to the Microbiology Laboratory at Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey, from the centers located in Kahramanmaras City center and peripheral districts of the province, between March 2010 and August 2014. The HCV genotype analysis was performed in HCV RNA positive samples, using RT-PCR reagents kit. Urine samples from the patients were tested for amphetamine with an Amphetamines II (AMPS2) kit, cocaine was tested with a Cocaine II (COC2) kit, opiates were tested with an Opiates II (OPI2) kit, and cannabinoids were tested with a Cannabinoids II (THC2) kit in Roche/Hitachi Cobas c501 device. RESULTS: The blood samples collected from 313 patients were included in the study. Of these patients, 212 (67.7%) were male and 101 (32.3%) were female. The mean age of the patients was 41.29 ± 20.32 years. In terms of HCV genotype distribution, 162 patients (51.7%) had genotype 1, 144 patients (46%) had genotype 3, four patients (1.3%) had genotype 2, and three patients (1%) had genotype 4. The results of urine drug tests were available in only 65 patients (20.2%). Of these, 61 (93.8%) patients had HCV genotype 3. CONCLUSIONS: In conclusion, the prevalence of HCV genotype 1 was 51.7%, which was lower than the rates reported in other studies in Turkey, while the prevalence of HCV genotype 3 was 46%, which was remarkably higher than the reported Turkish data. In addition, the prevalence rate for genotype 3 reported in the present study is the highest that has ever been reported in the literature.

[Comparison of direct microcopy and antigen casette tests for the detection of Giardia and Cryptosporidium]. / Giardia ve Cryptosporidium Tanisinda Direkt Mikroskobi ve Antijen Tarama Testlerinin Karsilastirilmasi

OBJECTIVE: The aim of this study was to compare the direct microscopy used for detection of intestinal parasites with antigen casette tests used in diagnosis of giardiasis and crypyosporidiasis. METHODS: Forty-six children who lived in the Sanliurfa Orphanage were enrolled in this study. The stool specimens were taken in the morning and examined by using native-lugol, modified formalin-ethylacetate concentration methods and cellophane tape method on the same day at the Microbiology laboratory of Harran University. Also Kinyoun-acid fast stained preparations were used for the detection of Cryptosporidium. R-biopharm Cryptosporidium/Giardia casette antigen test was used for the determinaton of giardiasis and crytosporidiasis. RESULTS: The mean age of the children enrolled in this study was 8.61±3.45 and the distribution of gender was 24 female (52.2%), 22 male (47.8%), respectively. According to stool examinations, 9 of 46 examples (19.60%) were determined as Giardia intestinalis, Cryptosporidium spp. had never been found. The result of the antigen screening casette test showed 9 of 46 samples (19.60%) were positive for G. intestinalis. Also Cryptosporidium spp. had never been found by the antigen casette test. CONCLUSION: When we compared the results of the direct microscopy and antigen casette tests, we found no significant difference between them for test reliability (p > 0.05). Antigen tests have higher sensitivity (100%) and specifity (100%) than the modified acid-fast staining technique, therefore, it is a preferred reference method . However, an experienced staff working accurately might access the same conclusion. Considering the cost of antigen tests, direct microscopic examination is cheaper, andeasier when it used by an experienced person.

[Post-operative bacteremia caused by multidrug-resistant Aerococcus viridans in a patient with gall bladder cancer]. / Safra kesesi kanseri olan bir hastada operasyon sonrasi gelisen cok ilaca dirençli Aerococcus viridans bakteriyemisi.

Aerococcus viridans is a gram-positive, catalase and oxidase negative, microaerophylic and non-motile coccus which is rarely associated with human infections such as endocarditis, meningitis, artritis and bacteremia. We report a case of bacteremia due to A. viridans in a 61-years-old man with malignant gall bladder neoplasm. The patient underwent a surgical operation and on the 5th day of operation he had severe abdominal pain, vomiting, high fever and discharge from operation site. He was transferred to intensive care unit and blood cultures were obtained. Piperacillin-tazobactam was initiated as empirical therapy. Blood cultures performed in Bactec system (Becton Dickinson, USA) yielded catalase negative, gram-positive cocci in tetrads. The isolate was pyrrolidonyl aminopeptidase (PYR) positive and produced alfa-hemolysis on sheep blood agar. These cocci were identified as A. viridans by Vitek 2 Compact System (BioMerieux, France) and identification was confirmed by using mini API System (BioMerieux, France). Antibiotic susceptibility testing performed with Kirby-Bauer disk diffusion method revealed that the isolate was susceptible to trimethoprim-sulfamethoxazole, tigecycline and vancomycin and resistant to penicillin, ampicillin, piperacillin-tazobactam, ceftriaxone, erythromycin, clindamycin and amikacin. The patient was successfully treated with vancomycin (2 x 1 g/day) and completely recovered without complication. In conclusion, A. viridans should be suspected as an opportunistic pathogen in immunocompromised patients and these patients should be treated according to the antibiotic susceptibility test results.