Community-acquired antimicrobial resistance among Syrian refugees and the local population in Türkiye.

BACKGROUND: The long-standing antimicrobial resistance (AMR) pandemic has proven difficult to resolve and is becoming more complex, especially in the context of increasing forced migration, with little evidence around patterns of AMR in migrant communities. This study aimed to determine the frequency in the carriage of common types of antimicrobial-resistant bacteria between Syrian refugees and the local communities in Türkiye: extended-spectrum ß-lactamase (ESBL), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). METHODS: We collected nasal swabs and stool samples from the study participants, the local community members, and refugees, between September 2020 and March 2021. We screened clinical samples for the presence of ESBL, MRSA and VRE. Antimicrobial-resistant bacterial isolates were tested by phenotypic analysis to determine the AMR status. RESULTS: The study included a total of 3960 participants: 1453 individuals in the local community (36.2%) and 2525 Syrian refugees (63.8%). Overall, a significantly greater proportion of refugees (6.7%) carried MRSA compared to the local community (3.2%) (P < 0.001). The ESBL-positivity rate was 17.9% in Syrian refugees and 14.3% in the local community (P = 0.041). Carbapenemase activity was detected in three isolates from Syrian refugees. No VRE was detected in Syrian refugees or the local community. CONCLUSIONS: This large, community-based study on the frequency and the distribution of AMR among Syrian refugees and the local population is the first study in Türkiye.

Bacterial diversity of loggerhead and green turtle eggs from two major nesting beaches from the Turkish coast of the Mediterranean.

This study was conducted during the 2018 nesting season at the Sugözü Beaches (Adana-Turkey) and Göksu Delta (Mersin-Turkey). Egg samples (n = 63) from loggerhead and green turtle nests (n = 43) were collected. Isolated bacteria were initially identified by phenotypic methods and then by MALDI-TOF MS. The bacterial mass spectra were analyzed using Principal Component Analysis. Bacterial isolation was performed for 55 isolates belonging to 12 genera from two major nesting sites. In Sugözü Beaches 62.2% of the bacteria species belonged to Enterobacteriaceae and in Göksu Delta 44.4% of the bacteria species belonged to Morganellaceae. Klebsiella oxytoca and Staphylococcus haemolyticus had not previously been detected in any sea turtle nests. This is the first MALDI-TOF MS study conducted for determination of bacterial variability in loggerhead turtle eggs in Turkey and serves as a reference study for the assessment of bacterial threat in sea turtle nests, enabling the establishment of suitable conservation measures and treatment processes for both sea turtles and nesting sites.

An evaluation of a Stenotrophomonas maltophilia outbreak due to commercial arterial blood gas collection kit.

BACKGROUND: Stenotrophomonas maltophilia is a gram-negative bacterium that can cause hospital infections and outbreaks within hospitals. This study aimed to evaluate an outbreak of Stenotrophomonas maltophilia, caused by ready-to-use commercial syringes containing liquid lithium and heparin for arterial blood gas collection in a university hospital. METHODS: Upon detecting an increase in Stenotrophomonas maltophilia growth in blood cultures between 15.09.2021 and 19.11.2021, an outbreak analysis and a case-control study (52 patients for the case group, 56 patients for the control group) were performed considering risk factors for bacteremia. Samples from possible foci for bacteremia were also cultured. Growing bacteria were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. The genetic linkage and clonal relationship isolates were investigated with pulsed-field gel electrophoresis (PFGE) in the reference laboratory. RESULTS: In the case-control study, the odds ratio for the central venous catheter [3.38 (95% confidence interval [CI]: 1.444, 8.705 ; p = 0.006)], for surgery [3.387 (95% confidence interval [CI]: 1.370, 8.373 ; p = 0.008)] and for arterial blood gas collection history [18.584 (95% confidence interval [CI]:4.086, 84.197; p < 0.001)] were identified as significant risk factors. Stenotrophomonas maltophilia growth was found in ready-to-use commercial syringes used for arterial blood gas collection. Molecular analysis showed that the growths in the samples taken from commercial syringes and the growths from blood cultures were the same. It was decided that the epidemic occurred because the method for sterilization of heparinized liquid preparations were not suitable. After discontinuing the use of the kits with this lot number, the outbreak was brought under control. CONCLUSIONS: According to our results, disposable or sterile medical equipment should be included as a risk factor in outbreak analyses. The method by which injectors containing liquids, such as heparin, are sterilized should be reviewed. Our study also revealed the importance of the cooperation of the infection control team with the microbiology laboratory.

A Fast Method for Detection of Fake Venoms and Investigation of Interspecies Variation Using Venoms of Androctonus, Buthus, and Leiurus (Scorpiones: Buthidae) Species.

Background: Within the scorpion family Buthidae, some of the most dangerous venomous genera are Androctonus (A), Buthus (B), and Leiurus (L). This venom is valuable raw material for numerous therapeutic formulations because of its pharmacological potential; however, because of its high prices in the global market, fake "venom mixes" are being made to market illegally, and it is important that these unknown mixes be evaluated. A fast and accurate response to the request for this identification is necessary. Method: This study was conducted in Turkey in 2022. Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS) is a linear positive-ionization mode was used for identification of scorpion species. The mass spectra of the three scorpion venoms were examined in detail. The peptide and protein profiles in the venoms of congenerous three scorpion venoms and the proportional differences in these venoms were investigated. For interspecific variation, a principal component analysis of all venoms was conducted, and variance values and distance-proximity indices were determined. Results: The top three peptide masses in the highest relative abundance for A. australis, B. mardochei, and L. quinquestriatus quinquestriatus, respectively, were 6901, 7431, and 7447; 4238, 5283, and 4055; and 3828, 7868, and 6799 Da. While the variance rate between A. australis and the other two venoms was 40%, this rate was 38% between B. mordochei and L. quinquestriatus quinquestriatus venoms. Conclusion: A very simple protocol of species identification using scorpion venom samples was created using recent advances in MALDI-TOF MS.