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1.
Am J Otolaryngol ; 43(3): 103458, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35413545

RESUMEN

OBJECTIVES: COVID-19 has seriously altered physicians' approach to patients and diseases, with a tendency to postpone elective procedures. Tonsillectomy, alone or with adenoidectomy, is one of the most common surgeries performed by otolaryngologists. Although they are generally accepted as elective surgeries, they significantly improve the quality of life, and postponing these surgeries for a long time can have deteriorative effects on the patients. We aimed to investigate the presence of SARS CoV-2 in the adenotonsillectomy materials to find out if performing adenotonsillectomy is safe during the COVID-19 pandemic. METHODS: Forty-eight tissue samples from 32 patients that underwent tonsillectomy with or without adenoidectomy were investigated whose SARS-CoV-2 RT-PCR test in the samples obtained from nasopharyngeal (NP) and oropharyngeal (OP) swabs were negative within 24 h before the operation. While 16 patients underwent only tonsillectomy and one of their tonsils was investigated, 16 of the patients underwent adenotonsillectomy and their adenoid tissues were sent along with one of their tonsils. SARS-CoV-2 viral RNA was investigated with Real-Time PCR in tissue samples. RESULTS: Two (4.2%) tissue samples had positive PCR tests for SARS-CoV-2, while 46 of them were negative. One of the positive patients had undergone tonsillectomy with the indication of chronic recurrent tonsillitis, and the other patient had undergone adenotonsillectomy for obstructive adenotonsillar hypertrophy. PCR test was positive in the adenoidectomy specimen and negative in the tonsillectomy specimen in this patient. CONCLUSIONS: Adenotonsillectomy can be done safely in asymptomatic patients without a history of Covid-19, with a negative PCR test result obtained within the last 24 h.


Asunto(s)
Tonsila Faríngea , COVID-19 , Tonsilectomía , Tonsilitis , Adenoidectomía/efectos adversos , Tonsila Faríngea/cirugía , Humanos , Tonsila Palatina/cirugía , Pandemias , Calidad de Vida , ARN Viral , SARS-CoV-2 , Tonsilectomía/métodos , Tonsilitis/etiología , Tonsilitis/cirugía
2.
Am J Emerg Med ; 37(10): 1912-1916, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-30658876

RESUMEN

INTRODUCTION: Appendicitis is the most common surgical disease evaluated by pediatric surgeons in the emergency department. Despite the history, physical examination, laboratory tests and imaging methods, the misdiagnosis may be observed often in children. Pentraxin-3 (PTX-3) is an acute phase protein which is produced directly in the inflammatory tissue. Our aim was to investigate the diagnostic value of PTX-3 levels in appendicitis in pediatric patients and compare it with the other serum parameters. METHODS: Eighty-eight patients (aged <18 years) were included in this study [Group 1 (n = 28) healthy volunteers, Group 2 (n = 28) patients with non-specific abdominal pain, Group 3 (n = 34) patients underwent appendectomy]. Serum white blood cell (WBC), absolute neutrophil count (ANC), neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) and PTX-3 values were measured. RESULTS: Median serum levels of WBC were higher in Group 2 and 3 than Group 1. ANS, NLR, CRP and PTX-3 were higher in Group 2 than Group 1 and were higher in Group 3 than the other groups. The highest sensitivity was found in NLR >3.5 [94.1 (95% CI = 80.3-99.3)] and PTX-3 > 5.6 ng/mL [91.8 (95% CI = 76.3-98.1)]. PTX-3 has the highest specificity among all of the parameters [90.7 (95% CI = 79.7-96.9)]. The area under the ROC curve showed that the diagnostic value of PTX-3 was greater than any other parameter [0.979 (95% CI = 0.92-0.99)]. CONCLUSION: In this study, we have shown that PTX-3 is very useful with high sensitivity and specificity in the diagnosis of appendicitis compared to WBC, ANS, NLR and CRP as a first in the literature.


Asunto(s)
Apendicitis/diagnóstico , Proteína C-Reactiva/metabolismo , Componente Amiloide P Sérico/metabolismo , Adolescente , Apendicitis/sangre , Biomarcadores/sangre , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Voluntarios Sanos , Humanos , Lactante , Recién Nacido , Masculino , Estudios Prospectivos , Sensibilidad y Especificidad
3.
Mikrobiyol Bul ; 50(4): 598-605, 2016 Oct.
Artículo en Turco | MEDLINE | ID: mdl-28124965

RESUMEN

Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S. Typhimurium, S. Choleraesuis and S. Schwarzengrund. In this report, we aimed to discuss a patient infected with ciprofloxacin-resistant Salmonella Kentucky under the light of data from our country and the world. A 52-year-old male patient wih acute myocardial infarction was hospitalized in intensive care unit of cardiovasculer surgery for left ventricular assist device (LVAD) implantation for the treatment of left ventricular disfunction. On the seventh day of LVAD and coronary artery bypass grafting (CABG), the patient presented high fever and productive cough. His physical examination revealed hyperemia around the insertion point of right jugular central venous catheter (CVC) and a serous discharge from the insertion point of LVAD located just below the inferior edge of sternum. Empiric IV cefoperazone/sulbactam (SCF) therapy was started with the prediagnosis of pneumonia and bloodstream infection. The blood samples taken from peripheral veins and CVC, and swabs taken from LVAD insertion point for culture when the patient was febrile, revealed the growth of bacteria with S type and lactose-negative colonies on EMB and SS media. Biochemical characteristics of the isolate were as follows: lactose fermentation negative, H2S positive, IMVIC (-,+,-,+), urease negative, lysine/ornithine decarboxylase positive and motile. The bacteria was then identified as Salmonella enterica serotype Kentucky (8,20;i;z6) by agglutination tests. Antibiotic susceptibility tests were conducted according to CLSI guidelines and it was found as ampicillin- and ciprofloxacin-resistant. Ciprofloxacin resistance of the isolate was confirmed with E-test. Stool culture was performed to investigate the source of infection, and S. Kentucky was isolated. On the 15th day of SCF treatment, LVAD was taken out, and tissue cultures taken from the fibrillar tissues between pericardial layers during surgery, also yielded S. Kentucky growth. On the second day of SCF therapy the patient's fever returned normal and on the seventh day, CBC and CRP values were normalized. Nevertheless, the clinical situation of the patient worsened gradually and on the 40th day he was intubated due to low oxygen saturation and pleural effusion. His antibiotherapy was stopped on 42nd day as the blood cultures were negative and his clinical situation was attributed to cardiac failure. The patient died four days after the antibiotherapy has stopped due to cardiac reasons. To our knowledge, this is the first reported case infected with ciprofloxacin-resistant Salmonella Kentucky in our country.


Asunto(s)
Antibacterianos/farmacología , Bacteriemia/microbiología , Ciprofloxacina/farmacología , Infecciones por Salmonella/microbiología , Salmonella enterica/efectos de los fármacos , Bacteriemia/complicaciones , Infecciones Relacionadas con Catéteres/microbiología , Catéteres Venosos Centrales/microbiología , Farmacorresistencia Bacteriana , Resultado Fatal , Corazón Auxiliar/microbiología , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/complicaciones , Infarto del Miocardio/cirugía , Infecciones por Salmonella/complicaciones , Salmonella enterica/clasificación
4.
Mikrobiyol Bul ; 49(2): 143-55, 2015 Apr.
Artículo en Turco | MEDLINE | ID: mdl-26167815

RESUMEN

The most effective method for monitoring country-level drug resistance frequency and to implement the necessary control measures is the establishment of a laboratory-based surveillance system. The aim of this study was to summarize the follow up trend of the drug-resistant tuberculosis (TB) cases, determine the load of resistance and evaluate the capacities of laboratories depending on laboratory quality assurance system for the installation work of National Tuberculosis Laboratory Surveillance Network (TuLSA) which has started in Ankara in 2011. TuLSA studies was carried out under the coordination of National Tuberculosis Reference Laboratory (NRL) with the participation of TB laboratories and dispensaries. Specimens of TB patients, reported from health institutions, were followed in TB laboratories, and the epidemiological information was collected from the dispensaries. One isolate per patient with the drug susceptibility test (DST) results were sent to NRL from TB laboratories and in NRL the isolates were rechecked with the genotypical (MTBDRplus, Hain Lifescience, Germany) and phenotypical (MGIT 960, BD, USA) DST methods. Molecular epidemiological analysis were also performed by spoligotyping and MIRU/VNTR. Second-line DST was applied to the isolates resistant to rifampin. A total of 1276 patients were reported between January 1st to December 31th 2011, and 335 cases were defined as "pulmonary TB from Ankara province". The mean age of those patients was 43.4 ± 20 years, and 67.5% were male. Three hundred seventeen (94.6%) patients were identified as new cases. The average sample number obtained from pulmonary TB cases was 3.26 ± 2.88, and 229 (68.3%) of them was culture positive. DST was applied to all culture positive isolates; 90.4% (207/229) of cases were susceptible to the five drugs tested (ethambutol, isoniazid, pyrazinamide, rifampicin, streptomycin). Eight (3.5%) of the isolates were multidrug-resistant (MDR-TB), while no extensively drug-resistant strains were detected. MDR-TB is likely to occur in 63.3 times more among previously treated cases, and 73.3 times more in legal aliens. The achievement of therapy among pulmonary TB cases was 91.9%. Spoligotyping performed for 221 M.tuberculosis complex isolates, showed that all strains were clustered in nine groups. SIT 41 (105/221; 47.5%) was the most frequent spoligotype detected, and clustering rate based on MIRU-VNTR results were found as 16.3%. All of the clustered strains were sensitive while all of MDR-TB isolates showed specific MIRU-VNTR profiles. In conclusion, TuLSA studies started in Ankara in 2011 and the system is still expanding in the country. Our data obtained with TuLSA have been published as a regional surveillance data in the WHO Global Tuberculosis Report 2011, and as a national surveillance data in Global Tuberculosis Report 2012.


Asunto(s)
Antituberculosos/farmacología , Mycobacterium tuberculosis/clasificación , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Pulmonar/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Antituberculosos/uso terapéutico , Niño , Preescolar , Análisis por Conglomerados , Farmacorresistencia Bacteriana Múltiple , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/aislamiento & purificación , Distribución por Sexo , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/microbiología , Turquía/epidemiología , Adulto Joven
5.
Eur J Med Res ; 29(1): 331, 2024 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-38880888

RESUMEN

BACKGROUND: Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are one of the most common causes of nosocomial infections and have high mortality rates due to difficulties in treatment. In this study, the in vitro synergistic interactions of the colistin (CT)-meropenem (MEM) combination and patient clinical outcomes were compared in CRAB-infected patients that receive CT-MEM antimicrobial combination therapy. In addition, in vitro synergistic interactions of MEM-ertapenem (ETP), MEM-fosfomycin (FF) and CT-FF antimicrobial combinations were investigated. Finally, the epsilometer (E) test and checkerboard test results were compared and the compatibility of these two tests was evaluated. METHODS: Twenty-one patients were included in the study. Bacterial identification was performed with MALDI-TOF, and antimicrobial susceptibility was assessed with an automated system. Synergy studies were performed using the E test and checkerboard method. RESULTS: For the checkerboard method, the synergy rates for CT-MEM, MEM-FF, MEM-ETP and CT-FF were 100%, 52.3%, 23.8% and 28.5%, respectively. In the E test synergy tests, synergistic effects were detected for two isolates each in the CT-MEM and CT-FF combinations. Microbial eradication was achieved in nine (52.9%) of the 17 patients that received CT-MEM combination therapy. The agreement between the E test and the checkerboard test was 6.5%. CONCLUSIONS: A synergistic effect was found with the checkerboard method for the CT-MEM combination in all isolates in our study, and approximately 70% of the patients benefited from treatment with this combination. In addition, more than half of the isolates showed a synergistic effect for the MEM-FF combination. Combinations of CT-MEM and MEM-FF may be options for the treatment of CRAB infections. However, a comprehensive understanding of the potential of the microorganism to develop resistant mutants under applied exposures, as well as factors that directly affect antimicrobial activity, such as pharmacokinetics/pharmacodynamics, is essential for providing treatment advice. We found a low rate of agreement between the E test method and the checkerboard test method in our study, in contrast to the literature. Comprehensive studies that compare clinical results with methods are needed to determine the ideal synergy test and interpretation method.


Asunto(s)
Infecciones por Acinetobacter , Acinetobacter baumannii , Antibacterianos , Carbapenémicos , Colistina , Pruebas de Sensibilidad Microbiana , Acinetobacter baumannii/efectos de los fármacos , Humanos , Colistina/farmacología , Carbapenémicos/farmacología , Masculino , Femenino , Persona de Mediana Edad , Pruebas de Sensibilidad Microbiana/métodos , Antibacterianos/farmacología , Antibacterianos/administración & dosificación , Anciano , Infecciones por Acinetobacter/tratamiento farmacológico , Infecciones por Acinetobacter/microbiología , Adulto , Sinergismo Farmacológico , Anciano de 80 o más Años , Quimioterapia Combinada/métodos , Meropenem/farmacología , Meropenem/administración & dosificación
6.
Diagn Microbiol Infect Dis ; 108(1): 116122, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37963419

RESUMEN

This study aimed to evaluate the antibody and T cell responses of homologous and heterologous booster doses for SARS-CoV-2 vaccines. Our study was performed on those with two doses of mRNA vaccine BNT162b2 (2B, n:44), those with heterologous booster dose BNT162b2 vaccine after two doses of inactivated vaccine CoronaVac (2S+1B, n:44), those with homologous booster dose vaccine CoronaVac after two doses of vaccine CoronaVac (3S, n:44) SARS-CoV-2 IgG antibody levels were significantly higher in individuals who received heterologous boosters(p<0.001). IFN-Ɣ, IL-2 and IL-13 median values were detected higher in 2S+1B group than in 3S group, respectively (p=0.112, p=0.057, p=0.341). Although the antibody levels in 2S+1B group were similar (p=0.153) to the 2B group; IFN-Ɣ, IL-2 and IL-13 levels were higher (p<0.001). In conclusion, supplementing an improved strategy based on inactivated vaccines with an mRNA vaccine as a heterologous booster is likely to be more beneficial in the course of the pandemic.


Asunto(s)
Vacuna BNT162 , COVID-19 , Humanos , Vacunas contra la COVID-19 , Vacunas de ARNm , Interleucina-13/genética , Interleucina-2 , COVID-19/prevención & control , SARS-CoV-2 , Inmunización , ARN Mensajero , Anticuerpos Antivirales
7.
J Infect Dev Ctries ; 17(10): 1446-1451, 2023 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-37956378

RESUMEN

INTRODUCTION: Klebsiella pneumonia causes serious infections in hospitalized patients. In recent years, carbapenem-resistant infections increased in the world. The molecular epidemiological investigation of carbapenem-resistant K. pneumoniae isolates was aimed in this study. METHODOLOGY: Fifty carbapenem-resistant K. pneumoniae isolates from six geographical regions of Turkey between September 2019-2020 were included in the study. The disk diffusion method was used for the antibiotic susceptibility testing. The microdilution confirmed colistin susceptibility. Genetic diversity was investigated by MLST (Multi-Locus Sequence Typing). RESULTS: The resistance rates were as follows: 49 (98%) for meropenem, 47 (94%) imipenem, 50 (100%) ertapenem, 30 (60%) colistin and amoxicillin-clavulanate, 49 (98%) ceftriaxone, 48 (96%) cefepime, 50 (100%) piperacillin-tazobactam, 47 (94%) ciprofloxacin, 40 (80%) amikacin, 37 (74%) gentamicin. An isolate resistant to colistin by disk diffusion was found as susceptible to microdilution. ST 2096 was the most common (n:16) sequence type by MLST. ST 101 (n:7), ST14 (n:6), ST 147 and ST 15 (n:4), ST391 (n:3), ST 377 and ST16 (n:2), ST22, ST 307, ST 985, ST 336, ST 345, and ST 3681 (n:1) were classified in other isolates. In Istanbul and Ankara ST2096 was common. Among Turkey isolates, the most common clonal complexes (CC) were CC14 (n:26) and CC11 (n = 7). CONCLUSIONS: In Turkey, a polyclonal population of CC14 throughout the country and inter-hospital spread were indicated. The use of molecular typing tools will highlight understanding the transmission dynamics.


Asunto(s)
Enterobacteriaceae Resistentes a los Carbapenémicos , Infecciones por Klebsiella , Humanos , Antibacterianos/farmacología , Colistina , Tipificación de Secuencias Multilocus , Klebsiella pneumoniae , Turquía/epidemiología , beta-Lactamasas/genética , Farmacorresistencia Bacteriana Múltiple/genética , Carbapenémicos/farmacología , Infecciones por Klebsiella/epidemiología , Unidades de Cuidados Intensivos , Pruebas de Sensibilidad Microbiana
8.
Mikrobiyol Bul ; 45(2): 280-7, 2011 Apr.
Artículo en Turco | MEDLINE | ID: mdl-21644071

RESUMEN

Human polyomaviruses, namely BK (BKV) and JC (JCV) viruses are small DNA viruses that cause latent infections worldwide. Primary infections are usually acquired in the early periods of life and are generally asymptomatic. However BKV/JCV infections may cause severe clinical conditions in immunosuppressive patients such as bone marrow and solid organ transplantation or cancer patients. The aim of this retrospective study was to investigate the presence of BKV and JCV nucleic acids by real-time polymerase chain reaction (RT-PCR) in the clinical samples of patients with high risk. A total of 268 (62 blood, 206 urine) samples obtained from 115 immunocompromised patients hospitalized in Gazi University Hospital between July 2007 to January 2009, were included to the study. Viral nucleic acids were extracted from the samples with High Pure PCR Template Preparation Kit (Roche, Germany). By using amplification mix (TIB Molbiol GmbH, Germany) that included primers targeting 174 (JCV) and 219 (BKV) base pair fragments of the small t antigen, and hybridization probes (Roche, Germany), nucleic acids were amplified with LightCycler (Roche Applied Science, Germany) system. As a result, total polyomavirus DNA positivity rate was found as 33.2% (89/268). When BKV and JCV DNA positivities were evaluated according to the samples, 25.2% (53/206) of urine samples yielded positive results for BKV, 14.5% (30/206) for JCV and 2.4% (5/206) for both BKV and JCV. Only one of the blood samples (1/62; 1.6%) were found positive by means of BKV DNA, while none of the blood samples were positive for JCV DNA. The distribution of BKV and JCV DNA positivity rates according to the inpatient clinics were as follows, respectively; 24.3% and 9.5% for pediatric nephrology, 9.6% and 8.2% for renal transplantation unit, 13.5% and 18.9% for adult nephrology, 30.8% and 15.4% for bone marrow transplantation unit, 22.9% and 8.6% for pediatric clinics. In samples from pediatric hematology patients, BKV positivity was 36.4% (4/11), while there were no JCV positivity. However, in hematology patients, while JCV was positive in one of the three samples, no BKV positivity was detected.BKV was seen in three of six samples obtained from patients in the intensive care unit. JCV was positive in both of the two samples obtained from patients in pediatric endocrinology. The only patient that had BKV DNA in blood sample was a renal transplant patient. BKV + JCV DNAs were positive together in only five (1.9%) of the urine samples. In 24% (22/89) of the samples, BKV DNA was found ≥ 107 copies/ml, in 2.2% (2/89) JCV DNA was ≥ 107 copies/ml, whereas in 2.2% (2/89) of samples both BKV and JCV DNA was ≥ 107 copies/ml. All of those samples with high DNA levels were urine. The data of this study led to the establishment of a collaborative algorithm between the laboratory and clinics in our hospital for the diagnosis and follow-up of the patients in terms of BKV/JCV infections. In conclusion, since BKV/JCV reactivations and infections are crutial in immunosuppressive patients, especially medical centers specialized in bone marrow and renal transplantation, diagnostic and monitoring procedures related to those infections should be programmed.


Asunto(s)
Virus BK/aislamiento & purificación , Huésped Inmunocomprometido , Virus JC/aislamiento & purificación , Infecciones por Polyomavirus/diagnóstico , Infecciones Tumorales por Virus/diagnóstico , Algoritmos , Virus BK/genética , Trasplante de Médula Ósea/efectos adversos , Trasplante de Médula Ósea/inmunología , ADN Viral/sangre , ADN Viral/aislamiento & purificación , ADN Viral/orina , Humanos , Virus JC/genética , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/inmunología , Neoplasias/complicaciones , Reacción en Cadena de la Polimerasa , Infecciones por Polyomavirus/epidemiología , Infecciones por Polyomavirus/etiología , Estudios Retrospectivos , Factores de Riesgo , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/etiología , Turquía/epidemiología
9.
Acta Otorhinolaryngol Ital ; 40(6): 457-462, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33558775

RESUMEN

OBJECTIVE: The aim of this study was to investigate the efficacy of N-acetylcysteine (NAC) on biofilm layers and on the course of disease in chronic otitis media. METHODS: Twenty-five rats that were induced with chronic otitis media (COM) were separated into three groups. In Group 1 (N = 18), 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate + 0.5 mg/ml NAC solution was locally injected to the right ear of the rats; in Group 2, (N=18) 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate was locally injected to the left ear of the rats. No treatment was applied to either ear of rats in Group 3 (N = 5). Histopathological and scanning electron microscope (SEM) evaluations were performed in all groups. RESULTS: SEM revealed biofilm formation in all COM induced groups. No significant difference was seen between groups 1 and 2 in terms of suppuration levels, fibrosis, inner ear involvement, infection staging and biofilm formation (p > 0.05). CONCLUSIONS: In this study, while histopathological and SEM evaluation revealed no effect of 0.5 mg/ml NAC on the biofilm layer in COM-induced rats, further studies with NAC at different concentrations are still needed on different types of experimental animals.


Asunto(s)
Otitis Media Supurativa , Otitis Media , Acetilcisteína/farmacología , Animales , Biopelículas , Humanos , Modelos Teóricos , Otitis Media/tratamiento farmacológico , Ratas
10.
J Infect Dev Ctries ; 12(1): 1-8, 2018 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31628827

RESUMEN

INTRODUCTION: In recent years, the prevalence of multidrug-resistant P. aeruginosa has remarkably increased. Thus, we wanted to investigate the carbapenem resistance mechanisms and clonal relationship among 80 carbapenem-resistant P. aeruginosa strains. METHODOLOGY: Carbapenemase production was detected using the Modified Hodge Test (MHT), EDTA combined disc method (ECD), and PCR. Expression levels of efflux and porin genes were mesured by real-time reverse transcription PCR. Clonal relationship of the isolates was investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: Carbapenemase production was detected in 7.5% of the isolates with MHT/ECD tests and in 11.3% of the isolates with PCR. Although the specificity of MHT/ECD was high, the sensitivitivity was low. oprD downregulation and mexB, mexY, and mexD overexpression were demonstrated in 55%, 16.3%, 2.5%, and 2.5% of the isolates, respectively. Multiple carbapenem resistance mechanisms were found in nearly a quarter of the isolates. PFGE typing of the 80 P. aeruginosa isolates yielded 61 different patterns. A total of 29 isolates (36.3%) were classified in 10 clusters, containing 2 to 7 strains. We could not find a strict relationship between PFGE profile and carbapenem resistance mechanisms. CONCLUSIONS: Although oprD downregulation and MexAB-OprM overexpression were the most common mechanisms, carbapenem resistance was associated with multiple mechanisms in the study. MHT/ECD tests should not be used alone for investigation of carbapenemase production in P. aeruginosa. Rapid tests with high sensitivity and specificity should be developed for the detection of carbapenemase production in P. aeruginosa.

11.
J Infect Dev Ctries ; 11(7): 543-548, 2017 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-31071063

RESUMEN

INTRODUCTION: The purpose of this study was to evaluate and compare two manual isolation and real-time (RT) polymerase chain reaction (PCR) kits (RTA RT-PCR with RTA isolation kit and Artus RG RT-PCR with QIAamp isolation kit) for molecular diagnosis of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. METHODOLOGY: The study was conducted on 121 and 54 clinical samples for the detection of HBV DNA and HCV RNA, respectively, with an additional 8 HCV RNA external quality control samples. RESULTS: Though a high correlation was observed between the two kits for the HBV DNA (r = 0.955, p = 0.001) and HCV RNA quantifications (r = 0.828, p = 0.001), discordant results were found in nine of the HBV DNA and in six of the HCV RNA samples. The mean difference between the two systems was found to be 0.4 log IU/mL in Quality Control for Molecular Diagnostics (QCMD) HCV RNA samples by Bland-Altman analysis. CONCLUSIONS: Although there was a high correlation between HBV DNA and HCV RNA tests according to the results of the study, the RTA system requires improvement for the determination of HCV RNA.

12.
J Med Microbiol ; 64(7): 759-766, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25976005

RESUMEN

This study aimed to determine the presence of vancomycin resistance (vanA and vanB) and virulence genes (esp, asa1, gelE, ace, hyl, cylA, cpd and ebpA) in vancomycin-resistant Enterococcus faecium (VREfm) strains and to analyse the clonal relationships among the strains. E. faecium strains were identified from rectal and clinical specimens by biochemical tests and the API-20 Strep kit. Susceptibility testing was performed using disc-diffusion and broth-dilution methods. PFGE was used for molecular typing of the VREfm strains. The vancomycin resistance and virulence genes were amplified by two-step multiplex PCR. All 55 VREfm isolates were resistant to penicillin G, ampicillin and high-level gentamicin but were susceptible to quinupristin/dalfopristin and linezolid. Multiplex PCR analysis indicated that all isolates harboured vanA and that 41 (75 %) were positive for virulence genes. The esp gene was the most common virulence factor and was detected in nine (41 %) invasive and 32 (96.7 %) non-invasive isolates. Multiple virulence genes were observed only in two non-invasive isolates; one harboured esp and ebpA and the other harboured esp, ebpA, asa1, gelE and cpd. PFGE typing yielded 16 different types, seven of which were clusters with two to 14 strains each. The clustering rates of the rectal swab, blood and urine isolates were 72.7 %, 61.5 % and 87.5 %, respectively. The genetic similarity observed among the VREfm isolates indicated cross-transmission in the hospital. Further studies on the virulence factors present in the strains might provide insight into the acquisition of these traits and their contribution to increased prevalence of VREfm.


Asunto(s)
Farmacorresistencia Bacteriana Múltiple/genética , Enterococcus faecium/genética , Infecciones por Bacterias Grampositivas/epidemiología , Resistencia a la Vancomicina/genética , Enterococos Resistentes a la Vancomicina/genética , Antibacterianos/farmacología , Proteínas Bacterianas/genética , Ligasas de Carbono-Oxígeno/genética , Enterococcus faecalis/efectos de los fármacos , Enterococcus faecalis/aislamiento & purificación , Enterococcus faecium/efectos de los fármacos , Enterococcus faecium/patogenicidad , Femenino , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Tipificación Molecular , Centros de Atención Terciaria , Turquía/epidemiología , Vancomicina/farmacología , Enterococos Resistentes a la Vancomicina/aislamiento & purificación , Enterococos Resistentes a la Vancomicina/patogenicidad , Factores de Virulencia/genética
13.
Rev. esp. quimioter ; 32(6): 516-524, dic. 2019. tab
Artículo en Inglés | IBECS (España) | ID: ibc-190610

RESUMEN

OBJECTIVES: The aim of this study was to determine the human papillomavirus (HPV) genotype distribution and to investigate the relationship between HPV genotypes and cervical cytology in women with HPV infection. MATERIAL AND METHODS: In this study, 493 women who were admitted to the obstetrics clinic between 2007 and 2015 years and had HPV positivity were examined retrospectively. RESULTS: The median age of women included in the study was 37.3 +/-10.6. The positivity of single and multiple HPV genotypes was 64.1% and 35.9%, respectively. HPV16 was the most common genotype in women with normal and abnormal cytology. The incidence of atypical squamous cells of undetermined significance (chi-square:8.32 p = 0.04) and high-grade squamous intraepithelial lesion (chi-square:13.75 p < 0.001) with HPV16 was significantly higher than in other HPV genotypes. In additional, abnormal cytology results in the group 1 (included HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) and group 4 (included HPV40, 42, 54, 55, 61, 62, 81, 83, 84) were significantly higher than other groups (chi-square:23.15 p < 0.001). CONCLUSIONS: Group 1 genotype ratios were found to be quite high among women with abnormal cytology and women with normal cytology. For this reason, close follow-up is very important in addition to cytological findings along with genotyping, especially from an early age. We were found that multiple HPV infection was not related to the grades of cytological abnormalities. Although abnormal cytology results in group 4 were significantly higher than the other groups, it was not possible to comment on the relationship between these genotypes and cervical cancer since more than one HPV genotype was found in most of these women


OBJETIVOS: El objetivo de este estudio fue determinar la distribución del genotipo del virus del papiloma humano (VPH) e investigar la relación entre los genotipos del VPH y la citología cervical en mujeres con infección por VPH. MATERIAL Y MÉTODOS: En este estudio, 493 mujeres que ingresaron en la clínica de obstetricia entre los años 2007 y 2015, y que presentaron VPH positivo fueron examinadas retrospectivamente. RESULTADOS: La edad media de las mujeres incluidas en el estudio fue de 37,3 +/- 10,6. La positividad de los genotipos de VPH individuales y múltiples fue de 64,1% y 35,9%, respectivamente. VPH16 fue el genotipo más común en mujeres con citología normal y anormal. La incidencia de células escamosas atípicas de importancia indeterminada (chi-cuadrado: 8,32 p: 0,04) y lesión intraepitelial escamosa de alto grado (chi-cuadrado: 13,75 p <0,001) con VPH16 fue significativamente mayor que en otros genotipos de VPH. Además, los resultados citológicos anormales en el grupo 1 (incluido VPH 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) y el grupo 4 (incluido el VPH 40, 42, 54, 55, 61, 62, 81, 83, 84) fueron significativamente más altos que en otros grupos (chi-cuadrado: 23,15 p <0,001). CONCLUSIONES: Se encontró que las proporciones de genotipos del grupo 1 fueron bastante altas entre las mujeres con citología anormal y las mujeres con citología normal. Por esta razón, el seguimiento cercano es muy importante además de los hallazgos citológicos junto con el genotipado, especialmente desde una edad temprana. Se encontró que la infección múltiple por VPH no estaba relacionada con los grados de anomalías citológicas. Aunque los resultados anormales de la citología en el grupo 4 fueron significativamente superiores a los otros grupos, no fue posible valorar la relación estos genotipos y el cáncer cervical ya que se encontró más de un genotipo de VPH en la mayoría de estas mujeres


Asunto(s)
Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Cuello del Útero/patología , Cuello del Útero/virología , Papillomaviridae/genética , Infecciones por Papillomavirus/virología , Genotipo , Papillomaviridae/aislamiento & purificación , Estudios Retrospectivos , Turquía , Frotis Vaginal
14.
Braz J Otorhinolaryngol ; 79(4): 418-23, 2013 Aug.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-23929139

RESUMEN

UNLABELLED: Epstein-Barr virus (EBV) is a well-known carcinogenic virus, and the association of EBV with some tumours suggests that there may also be an association between laryngeal carcinoma and EBV. OBJECTIVE: The aim of this study is to determine the role of EBV in the aetiology of laryngeal carcinoma. METHOD: Prospective investigation the EBV with real time polymerase chain reaction in tumour tissues of 25 patients with laryngeal carcinoma and 17 patients with benign laryngeal lesions, and investigation of the relationship between the presence of viral DNA and patients' smoking habits, alcohol consumption, localization and differentiation of the tumour. RESULTS: There was no significant difference between the control group and patient group in terms of EBV polymerase chain reaction positivity (p > 0.05). Also we couldn't find a statistically significant relationship between EBV positivity and differentiation of the tumour, localization of the tumour, smoking and alcohol consumption habits (p > 0.05). CONCLUSION: Our results suggest that, although EBV is present in some of the squamous cell laryngeal carcinomas, its presence has no effect on the pathogenesis of laryngeal carcinomas.


Asunto(s)
Carcinoma de Células Escamosas/virología , ADN Viral/análisis , Infecciones por Virus de Epstein-Barr/complicaciones , Herpesvirus Humano 4/genética , Neoplasias Laríngeas/virología , Adulto , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Carcinoma de Células Escamosas/patología , Estudios de Casos y Controles , Herpesvirus Humano 4/aislamiento & purificación , Humanos , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , Factores de Riesgo , Fumar/efectos adversos
15.
Braz. j. otorhinolaryngol. (Impr.) ; 79(4): 418-423, jul.-ago. 2013. tab
Artículo en Portugués | LILACS | ID: lil-681882

RESUMEN

O vírus Epstein-Barr (EBV) é um conhecido vírus carcinogênico. A associação entre EBV e alguns tumores sugere que também pode haver correlação entre carcinoma de laringe e EBV. OBJETIVO: O presente estudo pretende determinar o papel do EBV na etiologia do carcinoma de laringe. MÉTODO: Estudo prospectivo sobre EBV por reação em cadeia da polimerase em tempo real em tecidos tumorais de 25 pacientes com carcinoma de laringe e 17 pacientes com lesões benignas de laringe; análise da relação entre presença de DNA viral e tabagismo, etilismo, localização e diferenciação tumoral. RESULTADOS: Não houve diferenças significativas entre os grupos de controle e de estudo para positividade da PCR para EBV (p > 0,05). Não foi identificada relação estatisticamente significativa entre positividade para EBV e diferenciação tumoral, localização da neoplasia, tabagismo ou etilismo (p > 0,05). CONCLUSÃO: Nossos resultados sugerem que, a despeito de sua identificação em alguns carcinomas espinocelulares de laringe, a presença de EBV não teve qualquer influência na patogenia do carcinoma de laringe.


Epstein-Barr virus (EBV) is a well-known carcinogenic virus, and the association of EBV with some tumours suggests that there may also be an association between laryngeal carcinoma and EBV. OBJECTIVE: The aim of this study is to determine the role of EBV in the aetiology of laryngeal carcinoma. METHOD: Prospective investigation the EBV with real time polymerase chain reaction in tumour tissues of 25 patients with laryngeal carcinoma and 17 patients with benign laryngeal lesions, and investigation of the relationship between the presence of viral DNA and patients' smoking habits, alcohol consumption, localization and differentiation of the tumour. RESULTS: There was no significant difference between the control group and patient group in terms of EBV polymerase chain reaction positivity (p > 0.05). Also we couldn't find a statistically significant relationship between EBV positivity and differentiation of the tumour, localization of the tumour, smoking and alcohol consumption habits (p > 0.05). CONCLUSION: Our results suggest that, although EBV is present in some of the squamous cell laryngeal carcinomas, its presence has no effect on the pathogenesis of laryngeal carcinomas.


Asunto(s)
Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Escamosas/virología , ADN Viral/análisis , Infecciones por Virus de Epstein-Barr/complicaciones , /genética , Neoplasias Laríngeas/virología , Consumo de Bebidas Alcohólicas/efectos adversos , Estudios de Casos y Controles , Carcinoma de Células Escamosas/patología , /aislamiento & purificación , Neoplasias Laríngeas/patología , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , Factores de Riesgo , Fumar/efectos adversos
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