Prevalence of Helicobacter pylori in symptomatic patients and detection of clarithromycin resistance using melting curve analysis.

UNLABELLED: Abstract. BACKGROUND: Clarithromycin is often a component of combination therapies for Helicobacter pylori eradication; however, increases in resistance rates have decreased the success of the treatment. OBJECTIVE: This study was designed to determine the prevalence of H pylori infection in symptomatic patients and to detect clarithromycin resistance rates using melting curve analysis. METHODS: Patients scheduled for upper endoscopy at the Endoscopy Unit of the Department of Gastroenterology, Duzce University, Medical Faculty Hospital, Konuralp/Duzce, Turkey, were assessed for enrollment in the study. Two pairs of gastric biopsy specimens (antrum and corpus) were obtained from each study patient. Histopathologic examination, rapid urease test, culture, and polymerase chain reaction (PCR) of the specimens were used to identify H pylori infection. Clarithromycin resistance was detected using melting curve analysis. RESULTS: Seventy-five patients (41 women, 34 men; mean [SD]age, 42.6 [14.5] years [range, 17-70 years]) were included in the study. Using histopathology and rapid urease test, H pylori was detected in 40 (53.3%) of the 75 specimens. H pylori was detected using PCR in 40 (53.3%) specimens and by culture in 10 (13.3%) specimens. The specificity and sensitivity of PCR and culture were interpreted by comparing them with the results of histopathologic examination and urease tests. The specificity and sensitivity of PCR were 68.6% and 72.5%, respectively, and the specificity and sensitivity of culture were 97.1% and 22.5%, respectively. Of the 40 isolates, 21 (52.5%) were susceptible to clarithromycin, 12 (30.0%) were resistant, and a mixed susceptibility pattern was detected in 7 (17.5%) specimens. H pylori isolates from 19 (79.2%) of the 24 patients who had formerly used clarithromycin showed clarithromycin resistance. CONCLUSIONS: The prevalence of H pylori infection was 53.3% for the symptomatic patients in this study, and 47.5% of the isolates showed clarithromycin resistance using melting curve analysis. The PCR-based system used in this study was accurate for the detection of H pylori infection as well as clarithromycin susceptibility testing directly in biopsy specimens.

[Investigation of erythromycin resistance and resistance phenotypes in group A beta hemolytic streptococci]. / A grubu beta-hemolitik streptokoklarda eritromisin direnç oranlarinin ve direnc fenotipinin arastirilmasi.

Although penicillin resistance has not been determined in group A beta haemolytic streptococci (GABHS) yet, resistance to erythromycin and other macrolids is being reported frequently in the last years. In this study we investigated erythromycin resistance by using agar dilution method in 282 GABHS strains which were isolated from throat cultures that had been evaluated in the Ministry of Health, Ankara Training and Research Hospital's, Microbiology Laboratory. We also determined resistance phenotypes of resistant strains by double disc synergy method using erythromycin and clindamycin discs. Twelve of 282 strains (4.3%) were found resistant to erythromycin; five (41.7%) of which were M phenotype, four (33.3%) of which were constitutive type MLSB phenotype and three (25%) of which were inducible type MLSB phenotype. Investigation of resistance to macrolides that are alternatives to penicillin therapy in GABHS, is very important for the determination of the therapy and also to provide epidemiological data.

[Short communication: investigation of Toxoplasma gondii antibodies in blood donors by Sabin-Feldman Dye Test]. / Kisa bildiri: kan bagilsçilarinda Toxoplasma gondii antikorlarinin Sabin-Feldman Boya testi ile arastirilmasi.

In this study, a serological survey of Toxoplasma gondii infection in healthy blood donors admitted to Blood Center of Ministry of Health, Ankara Training and Research Hospital was carried out. Sera from 390 male and 24 female (ages between 18-59 years) were evaluated by using Sabin Feldman Dye Test (SFDT). Of 414 donors 176 (42.5%) were found positive for T. gondii antibodies. Among the seropositive cases, 106 (25.6%) had 1/16, 40 (9.7%) had 1/64, 28 (6.8%) had 1/256, and two (0.5%) had 1/1024 SFDT titers. The seropositivity rates for females and males were found as 62.5% and 41.3%, respectively, and there was no statistically significant difference (p=0.053). A statistically significant increase was detected in the seropositivity rates with age, 39% being under the age of 40 (18-39 years), 54% over the age of 40 (p<0.01). In conclusion, although it is not necessary to screen the blood donors routinely for T. gondii antibodies, if the transfusion of cellular blood components is planned for immunosuppresive recipients, then those bloods should be tested for T. gondii antibodies.