Investigation of BK Virus by Real-Time Polymerase Chain Reaction in Patients With Allogeneic Bone Marrow Transplantation.

INTRODUCTION: BK virus (BKV) is a common human polyomavirus and causes latent infection. Especially in immunosuppressive patients, early diagnosis and treatment are very important in reducing the high mortality rate. In this study, we investigated BKV DNA in serum and plasma and urine specimens by real-time polymerase chain reaction (PCR) method in allogeneic hematopoietic stem cell transplantation patients. MATERIALS AND METHODS: BKV DNA was isolated in QIAsymphony SP/AS (Hilden, Germany) equipment using QIAsymphony DSP Virus/Pathogen Midi Kit, Version 1 (QIAGEN, Hilden, Germany) in urine and serum samples collected from 100 patients post-transplantation. Artus BKV QS-RGQ, V1 (Qiagen, Hilden, Germany) kit for BKV PCR was prepared according to the company recommendations and loaded on Qiagen Rotor Gene (Hilden, Germany). It was evaluated with PCR, and >27 copies/mL was considered as positive. RESULTS: BKV DNA was positive in 57% of the urine specimens obtained; only 25% of the patients were found to have a significant BKV burden in the urine according to the American Society of Transplantation, suggesting a risk of developing nephropathy. Serum samples of the same patients were negative for BKV DNA in 94 cases and they were positive for BKV DNA at interval between 44 and 319 copies/mL in 6 patients, and none of the patients had clinically significant BKV DNA in serum samples. CONCLUSIONS: Monitoring the viral load with urine samples were thought to be more convenient for the detection of BKV reactivation in our study.

Evaluation of two different hand hygiene procedures during routine patient care.

In this study, the antimicrobial efficacy of hand washing (HW) and hand washing plus rubbing with an alcohol-based solution (HWR) on numbers of total and transient flora colonies on the hands of healthcare workers (HCWs) during routine patient care was assessed. Samples were collected, using a standard bag broth technique, from the hands of 154 HCWs, before and immediately after carrying out a hand hygiene procedure. The numbers of total and transient flora colonies per plate were counted and transient pathogens were identified. A significant statistical difference between ward speciality was detected with respect to the isolation rate of transient flora. Transient hand flora were recovered from 25.3% of HCWs before carrying out the hand hygiene procedure. With respect to the disappearance and prevention of regrowth of transient flora after hand hygiene, the HWR technique was significantly more effective than HW. In conclusion, a disinfectant should be added to the hand washing process to achieve optimum protection against nosocomial infections in routine hospital practice.

Prevalence of hepatitis E virus antibodies in patients with chronic hepatitis B and chronic hepatitis C.

OBJECTIVES: To investigate the prevalence of hepatitis E virus (HEV) among patients with chronic hepatitis B and chronic hepatitis C, serum samples were collected between January and December 2004 from patients with chronic hepatitis B and chronic hepatitis C. METHODS: There were 190 adult patients with chronic hepatitis B virus (HBV) and 174 with chronic hepatitis C virus (HCV) infection in the study group. As the control group, a cohort of 178 age- and sex-matched individuals without known liver disease was selected. RESULTS: Anti-HEV IgG antibodies were positive in 26/190 (13.7%) of chronic HBV and 94/174 (54%) of chronic HCV patients. In the control group anti-HEV positivity was 15.7% (28/178). There was no difference in the percentage of chronic HBV patients and control group who were positive for anti-HEV antibody, but the presence of HEV infection was significantly higher in chronic HCV patients. CONCLUSIONS: Our findings suggest that HEV and HCV might share a common route of transmission in our region. We recommend that preventive measures against HEV should be undertaken in chronic HCV patients as superinfection with HEV can cause a more severe pattern of disease in chronic hepatitis patients.

Comparison of clinical diagnosis and microbiological test results in vaginal infections.

Lower genital tract infections continue to be a problem due to the fact that the clinical diagnosis is usually inadequate, and subsequent care is suboptimal. This study aimed at evaluating the accuracy of clinical diagnosis by comparing it with microbiologic test results, and to determine the causative agents of vaginal infections. Sixty-seven nonpregnant women (18-45 years of age) with the clinical diagnosis of lower genital tract infection were enrolled in the study. Patients were not included if they had a history of vaginal infection during the previous three-month period or intrauterine device. The clinical diagnosis was based on the combinations of symptoms, direct observation of wet mount, homogeneous discharge, vaginal pH > 4.5, and detection of the amine odor after exposure of vaginal secretions to 10% KOH. Vaginal samples were taken with two cotton swabs, one was used for pH determination, and the second was utilized for microbiological tests. Gram staining and cultures with Sabouraud agar and chocolate agar were performed for microbiological diagnosis, and the results were compared. The clinical diagnoses included 26 (38.8%) candidiasis, 18 (26.8%) bacterial vaginosis, three (4.5%) trichomoniasis, and 20 (29.9%) mixed vaginal infections. Of the 26 patients with clinical diagnoses of candidiasis, 12 (46.1%) revealed Candiada albicans, nine (34.6) patients revealed microorganisms other than candida species, and five (19.2%) patients had no growth. Five (27.8%) bacterial vaginosis patients revealed Gardnarella vaginalis and 12 patients (66.6%) did not grow any microorganism. The overall rate of accurate clinical diagnoses confirmed by microbiological test results was 43.2%. Seventeen (43.6) of the 39 microbiological test results correlated with clinical diagnosis, and no growth was observed in 28 (41.8%) cultures. We conclude that the clinical diagnosis of vaginal infection is inadequate and should be confirmed with microbiological testing if the resources are avaliable.

Coryneform bacteria isolated from blood cultures and their antibiotic susceptibilities.

We aimed to determine the types of corynebacteria isolated from the blood of patients at Gaziantep University Hospital, Turkey, and their antibiotic susceptibilities. Between February 1999 and June 2001, 3530 blood samples were cultured, of which 915 were found to be positive, and these were further investigated in the bacteriology laboratory. Among positive blood cultures, coryneform bacteria were identified in 31 (3.4%) isolates. Of these, 16 (51.6%) were Corynebacterium jeikeium, six (19.4%) were Corynebacterium striatum, four (12.9%) were Corynebacterium amycolatum, two (6.5%) were Cellulomonas species, two (6.5%) were Corynebacterium afermentans and one isolate (3.2%) was Corynebacterium propinquum. Antibiotic susceptibility tests showed that C. jeikeium was resistant to various antibiotics, whereas all isolates were susceptible to vancomycin and teicoplanin. This study illustrates the importance of taking coryneform bacteria into consideration when culturing blood samples. The need to identify the species and determine its antibiotic sensitivity is emphasized.