Relationship between Blastocystis spp. with Accompanying Food Hypersensitivity and Chronic Spontaneous Urticaria.

INTRODUCTION: The relationship between Blastocystis spp. and chronic spontaneous urticaria (CSU) is unclear. The aim of this study was to evaluate the role of this parasitic infection on CSU and to search for risky groups in CSU patients with this parasite. METHODS: Seventy adult CSU patients with Blastocystis spp. in their stool samples forming Group A and 70 CSU patients without any parasite as Group B were prospectively compared regarding urticaria activity score-7 (UAS7), medication scores (MS), and laboratory parameters. All patients received CSU treatment, and additionally, those in group A received an antiparasitic antibiotic. Eight months later, the same parameters were compared between the ones in remission (group A1) and those still having CSU symptoms (group A2) in group A. RESULTS: UAS7 and MS were lower in group A than in group B (p: 0.007, p < 0.001) 8 months later, while the initial scores were similar. The presence of food hypersensitivity reactions (FHRs) was higher in group A than in group B (p < 0.001) and was detected as a significant risk factor in the presence of Blastocystis spp. infection (p: 0.002, OR [CI] = 0.151 [0.045-0.502]). In group A, UAS7, MS, serum total IgE levels, and blood eosinophil counts decreased 8 months later (p < 0.001, p < 0.001, p: 0.003, p: 0.004, respectively). Additionally, total IgE levels and eosinophil counts decreased in group A1 (p: 0.033, p: 0.002) while they did not change in group A2. DISCUSSION/CONCLUSION: The eradication of Blastocystis spp. can improve the disease activity in CSU and the presence of FHRs seems to be risky in CSU patients with Blastocystis spp.

[Nitrate reductase assay for the rapid detection of Staphylococcus aureus methicillin resistance: a breakpoint susceptibility testing method]. / Staphylococcus aureus metisilin direncinin hizli saptanmasinda nitrat redüktaz testi: Bir sinir deger duyarlilik test yöntemi.

Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of hospital- and community-acquired infections. Therefore rapid and accurate detection of MRSA is essential for infection control and prevention of nosocomial spread. In this study, the efficacy of a nitrate reductase assay (NRA) as a breakpoint susceptibility testing method was evaluated for the rapid detection of methicillin resistance in S.aureus A total of 135 S.aureus clinical isolates from our collection were tested for methicillin susceptibility by NRA breakpoint susceptibility method and by broth microdilution method. For NRA breakpoint susceptibility testing three tubes including growth control tube (without drug), test tube (with 4 mg/L cefoxitin) and lyophilized test tube (with 4 mg/L cefoxitin) were used. 50 µl of 0.5 McFarland bacterial suspension of each isolate was inoculated into the tubes. All tubes were incubated at 35ºC. After five-hour incubation, 500 µl of freshly prepared reagent [2 units of 0.2% sulfanilamide, 2 units of 0.1% N-(1-naphthyl) ethylenediamine dihydrochloride and 1 unit of concentrated hydrochloric acid] was added into each tube and a color change was watched for. The color changed to violet/purple, if there was bacterial growth. If the color changed to violet/purple in all three tubes, the isolate was identified as methicillin-resistant. If the color changed in growth control tube but not in the test and lyophilized tube, the isolate was identified as methicillin-susceptible. Among 135 isolates tested, 97 had mecA gene and were methicillin-resistant by both microdilution and NRA breakpoint susceptibility method. The remaining 38 clinical isolates did not have this gene and were susceptible to methicillin by both methods used. All results were concordant to the PCR which was considered as the gold standard method. Specificity, sensitivity, positive and negative predictive values were 100%. NRA breakpoint susceptibility test in tubes is an inexpensive and reproducible method. This method can easily be used in many laboratories and does not require skilled personnel. In addition, test tubes are prepared by lyophilisation to provide long shelf-life which gives an important advantage.