[Investigation of Pneumocystis jirovecii in Respiratory Samples of Immunocompromised Patients with PCR, IFA and Giemsa Staining Methods]. / Immün Yetmezligi Olan Hastalarin Solunum Yolu Örneklerinde PCR, IFA ve Giemsa Boyama Yöntemleriyle Pneumocyctis jirovecii'nin Arastirilmasi

Pneumocystis jirovecii is an important opportunistic agent leading to pneumonia in immunocompromised patients. In this study, the presence of P.jirovecii were investigated by using Giemsa stain, indirect fluorescent antibody (IFA) test and two different nested polymerase chain reaction (nPCR) assays in respiratory samples obtained from 50 immunocompromised patients presenting with respiratory symptoms. The target genes used for nested PCR were mitochondrial large subunit ribosomal RNA (MtLSUrRNA) and internal transcribed spacer (ITS) region. P.jirovecii was detected in 7 (14%) and 11 (22%) respiratory samples by IFA and PCR, respectively, although all samples were negative with Giemsa stain. As a result, IFA and PCR were found to be rapid and reliable tests for the diagnosis of P.jirovecii infections and they should better be used together for accurate diagnosis.

[Resistance rates of Mycobacterium tuberculosis complex strains isolated from clinical specimens]. / Klinik Örneklerden Izole Edilen Mycobacterium tuberculosis Kompleks Suslarinin Antibiyotiklere Direnç Oranlari

The aim of this study was to investigate isoniazid, rifampicin, streptomycin and ethambutol resistance rates of Mycobacterium tuberculosis complex strains isolated from clinical specimens in the Mycobacteriology Laboratories of Karadeniz Technical University Hospital between January 2005-March 2010. A total of 212 M.tuberculosis complex strains, 152 (71.7%) of which were isolated from respiratory specimens and 60 (28.3%) from non-respiratory system specimens, were included to the study. M.tuberculosis complex strains were determined by polymerase chain reaction using primers specific for the IS6110 gene region. Single isolate of each patient were enrolled in the study. Antituberculosis drug susceptibility testing was performed by BACTEC MGIT 960 (Becton Dickinson, USA). Of the 212 isolates, 157 (74.05%) were susceptible to all of the four antimycobacterial agents while 55 (25.9%) were found resistant to one or more of the drugs. The monodrug resistance rates were found as 6.1% for isoniazid, 0.5% for rifampicin, 5.2% for streptomycin, and 2.4% for ethambutol. The number of multidrug resistant isolates characterized with resistance to isoniazid and rifampicin were 10 (4.8%). Our findings indicated that the rates of mono and multidrug resistant M.tuberculosis complex strains were significantly lower than the rates previously reported from our region and similar to the average country-base resistance rates reported by the Ministry of Health. Continuous monitoring of M.tuberculosis antimicrobial resistance at regional level would greatly aid to the success of the tuberculosis surveillance program in Turkey.