Evaluation of purified antigen fraction in the immunodiagnosis of cystic echinococcosis.

Echinococcus granulosus antigen B fraction (AgB) was evaluated for its prognostic value in the serological follow-up of cystic echinococcosis (CE), compared to crude hydatid fluid (HF) as well as soluble somatic Echinococcus multilocularis antigen (Em). The sensitivity and specificity of enzyme-linked immunosorbent assays (ELISA) were compared examining 177 sera from patients with different clinical courses and outcome of CE and with other parasitic infections. AgB-ELISA in comparison to confirmed cystic echinococcosis has 96.4% sensitivity and 97.2% specificity, with 93.1% positive predictive value and 98.6% negative predictive value. The HF-ELISA was more sensitive than the AgB-ELISA, but its specificity was lower. Our results indicate that AgB-ELISA was more satisfactory for seroconfirmation of acute echinococcosis than HF-ELISA. Moreover, the AgB-ELISA has a potential key role in control measures implemented in patients undergoing surgery. In sera of patients more than 3 months after the treatment, no antibody response to antigen B was detected; however, with conventionally used HF-ELISA, they were still positive. The AgB is recommended for the confirmatory diagnosis. AgB-WB allocated low background with typical "triplet" bands at 8-12-16 kDa.

[Monthly distribution of intestinal parasites detected in a part of western Turkey between May 2009-April 2010-results of acid fast and modified trichrome staining methods]. / Izmir ve Çevresinde Bir Yilda (Mayis 2009-Nisan 2010) Saptanan Bagirsak Parazitlerinin Aylara Göre Dagilimi-Asid Fast ve Modifiye Trichrome Boyama Sonuçlari.

OBJECTIVE: In this study, 5073 fecal specimens and cellophane tapes from patients were examined during the period of May 1, 2009-April 30, 2010 in the parasitology laboratory of the Ege University Medical School. METHODS: Sticky tape test and ethyl acetate sedimentation methods, saline, iodine, modified kinyoun's acid-fast, Trichrome, modified Trichrome and giemsa staining procedures have been applied to the stool samples. RESULTS: After the macroscopic and microscopic examinations, 1138 (22.43%) intestinal parasites were determined. Cryptosporidium spp. (n=381; 33.47%), Blastocystis hominis (n=368; 32.33%) and Cyclospora spp. (n=187; 16.43%) were the three most common parasites obtained during the examination. The most commonly determined helminth was Enterobius vermicularis (n=33; 2.89%). CONCLUSION: Detection of Microsporidium spores in immununosuppressed patients showed also the importance of specific staining methods. Intestinal parasites are causing serious public health problems in our region.

Degree and frequency of inhibition in a routine real-time PCR detecting Pneumocystis jirovecii for the diagnosis of Pneumocystis pneumonia in Turkey.

Routine laboratory diagnosis of Pneumocystis jirovecii is currently achieved by PCR in almost all laboratories with sufficient equipment due to its high sensitivity and specificity compared to staining methods. A current issue that limits the reliability and sensitivity of PCR is the degree of inhibition caused by inhibitory substances in respiratory samples. The present study aimed to analyse the degree and frequency of inhibition in real-time PCR detecting P. jirovecii in respiratory specimens submitted to a Pneumocystis pneumonia (PcP) diagnosis laboratory in Ege University Medical School, Turkey. Between July 2009 and December 2010, 76 respiratory specimens [63 bronchoalveolar lavage (BAL) fluid, 10 sputum samples, two tracheal aspiration fluid and one thoracentesis fluid] obtained from 69 PcP-suspected patients were investigated for the presence of P. jirovecii using real-time PCR targeting the cdc2 gene. Of these samples, 42 of the specimens were stained and examined by microscopy according to the request of the clinicians. PCR was positive in 15 specimens in the initial run. Of the remaining 61 samples, 41 of them were negative with positive internal inhibition controls (i.e. true-negative group). The frequency of inhibition in the initial run was 26.31 % (20/76) as determined by spiked negative controls. All of the inhibited samples were resolved after 1 : 2, 1 : 5, 1 : 10 and 1 : 20 dilutions. P. jirovecii was detected by PCR in two inhibited specimens after retesting with diluted samples which were also positive by microscopy. The incidence of P. jirovecii in respiratory specimens was 22.36 % (17/76) as determined by real-time PCR and 7.14 % (3/42) by microscopy. Overall, the incidence of P. jirovecii in respiratory samples was 23.68 % (18/76) as detected by both methods. In conclusion, inclusion of spiked positive controls in each sample and retesting with diluted samples to resolve inhibition increased the reliability of the real-time PCR assay in terms of determining false-negative results and influencing the treatment of the patient. Furthermore, results of the present study determined for the first time the frequency and degree of inhibition in a real-time PCR detecting P. jirovecii in respiratory specimens during routine diagnosis of PcP.

[The investigation of Entamoeba gingivalis and Trichomonas tenax in a group of patients with periodontal disease]. / Periodontal Hastaligi Bulunan Kisilerde Dis Eti Plaklarinda Entamoeba gingivalis ve Trichomonas tenax Arastirilmasi.

The oral cavity is suitable for invasion of many microorganisms. Entamoeba gingivalis (E.gingivalis) and Trichomonas tenax (T.tenax) settle in the oral cavity of patients with poor oral hygiene and gingival disease. In the present study, two slide specimens were prepared from the cole region of the teeth of 46 persons for investigation of the parasites. One of the slide specimens was dried in the air while the other one put into fixative and they were stained with trichrome and Giemsa stains. The two staining methods were used for 36 samples and only Giemsa, for 10 samples. E. gingivalis was positive in 7 (19.44%) out of 36 samples stained by the trichrome stain while T. tenax was positive in one (2.17%) out of 46 samples stained by Giemsa stain. Parasitic infections were found to be positive in seven (21.2%) specimen from 33 patients with periodontal disease and in one (7.69%) specimen from 13 healthy controls. Dental policlinics are generally far from parasitology laboratories and microscopical wet mount examination can not be performed. Therefore dentists can send the specimens and have the parasites diagnosed with Giemsa and trichrome staining methods as an alternative to wet mount examination.

[A rare gastroenteritis pathogen: Cyclospora]. / Nadir Bir Gastroenterit Etkeni: Cyclospora.

Cyclospora spp. which are coccidian parasites are rare gastroenteritis pathogens. The first cyclosporiasis case in Turkey was reported in 1998 in a patient with AIDS. In this paper we report a case of Cyclospora gastroenteritis, in a patient who was admitted to our hospital and who had had diarrhea, abdominal pain and nausea for ten days. In the anamnesis it was learned that he had travelled to the Black Sea region and had drunk muddy and cloudy water. His physical examination was normal except for increased bowel sounds. There were no leukocytes or erythrocytes in the direct microscopy of the stool and bacteriologic culture did not yield any enteropathogen. Cylospora oocyysts were seen in the parasitologic exmination. The patient was treated with cotrimaxasole (2x1,160/800 mg tablet). There was no pathogen in the repeated stool examination. Our case suggests that parasitologic examination should not be neglected in longlasting diarrhea cases and occasionally Cyclospora may be the causative agent.

The investigation of congenital toxoplasmosis in a tertiary care hospital in Turkey.

OBJECTIVE: To elucidate the prevalence of congenital toxoplasmosis in Turkey. METHODS: This study was conducted in the Department of Parasitology, Faculty of Medicine, Ege University, Izmir, Turkey during the period of 2006 and 2007. Venous blood before delivery and cord blood during delivery were collected from 138 women, and we observed the presence of immunoglobulin (Ig)G and IgM antibodies by Enzyme Linked Immunosorbant Assay (ELISA), western blotting, and other serologic tests. RESULTS: The combination of ELISA and western blotting have the greatest sensitivity among the serological techniques used. The results of the cord and venous sera were comparable with no significant difference, except for one sample. CONCLUSION: Data obtained showed that early characterization of IgG antibodies synthesized by congenitally infected newborn is important. This preliminary study sets an example to the studies that would help both in determining the incidence of congenital toxoplasmosis by screening larger populations and in preventing sequels by early diagnosis.

[Distribution of intestinal parasites detected in the parasitology laboratory of the Ege University Medical School Hospital, in 2005]. / Ege Universitesi Tip Fakültesi Hastanesi parazitoloji laboratuvarinda 2005 yili boyunca saptanan bagirsak parazitlerinin dagilimi.

The aim of this study was to determine the parasite frequency in 3925 patients during 2005 from January 1- December 31 in the parasitology laboratory of the Ege University Medicine School. During the laboratory investigation, 3925 fecal specimens and cellophane tapes from the patients were examined. After the microscope examination of 3925 feces samples, it was found that 590 (15.03%) of these samples contained one or more intestinal parasites. Blastocystis hominis (4.96%), Cyclospora spp. (1.91%), Enterobius vermicularis (1.86%), Entamoeba coli (1.78%) and Giardia intestinalis (1.78%) were the five most common parasites obtained during the examination.

Incidence of cyclosporiasis in patients with gastrointestinal symptoms in western Turkey.

BACKGROUND: This study was designed to investigate the distribution of cyclosporiasis between October 2003 and October 2004 and the relationship between Cyclospora infection and seasonal as well as patient factors in western Turkey. MATERIAL/METHODS: Stool samples from 4660 immunocompetent patients with gastrointestinal symptoms and 326 immunocompetent patients with allergic symptoms from western Turkey were examined between October 2003 and October 2004 using wet preparation, formalin-ethyl acetate concentration, Trichrome stain, and modified Kinyoun's acid-fast staining methods. RESULTS: Twenty-three patients were found to be infected with Cyclospora oocysts. Parasites such as Cryptosporidium, Giardia intestinalis, Entamoeba histolytica/dispar, Blastocystis hominis and others were also observed. The incidence of cyclosporiasis was higher in summer and early autumn and most of the Cyclospora-infected patients were without diarrhea. CONCLUSIONS: Clinicians with patients from Turkey and abroad who have intestinal symptoms after visiting the country should be aware that Cyclospora infections could be considered as a possible cause of gastrointestinal symptoms in the absence of diarrhea in immunocompetent patients during the summer period in Turkey.

[A human case of cyclosporiasis after traveling in the subtropics]. / Yurtdisi seyahat hikayesi olan bir cyclosporiasis olgusu.

In this study, Cyclospora oocysts were detected in a 64-year old man who complained of persistent diarrhea, abdominal pain, nausea and vomiting after visiting the Greek Islands in a sailing boat. Round oocysts about 8-9 microm in size with wrinkled walls that varied in color from red to pale pink after staining were found in Kinyoun's modified acid fast stained stool samples. Public health offices and laboratories, general practitioners, and medical microbiology labs should be informed that more attention should be paid to cyclosporiasis causing diarrheal illness and which requires specific screening methods with experienced microscopists in laboratories.

[A study of sister chromatid exchange (SCE) in patients with liver cystic hydatid disease who have been treated with albendazole.]. / Karaciger kist hidatigi tedavisinde albendazol kullanan hastalarda kardes kromatid degisimi (SCE) çalismasi

A total of 21 patients including 13 females and 8 males who presented at the Microbiology and General Surgery Departments of the Atatürk Research and Training Hospital with complaints of liver cystic hydatid disease have been included in this study. Albendazole was administered to these cystic hydatid patients before and after surgery. The aim of this study was to investigate the probable genotoxic effects of albendazole. SCE testing was applied to the blood samples taken from patients after the treatment and the mutagenic effect of albendazole was investigated by comparison with the control group. Student t- test was used for the statistical analysis of the results.