Molecular characterization and antimicrobial susceptibility of methicillin-resistant staphylococcus aureus isolates from clinical samples and asymptomatic nasal carriers in Istanbul (Turkey).

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has been a widespread problem in Turkish hospitals. AIMS: The aim of this study was to investigate the staphylococcal toxin genes of the clinical and nasal MRSA isolates, and their antibiotic resistance profiles. MATERIALS AND METHODS: Isolation of nasal and clinical bacteria was done following standard microbiological methods. The presence of antimicrobial resistance genes (mec A, pvl, tsst-1, and SEs genes) was determined using the real-time polymerase chain reaction (PCR) assay. RESULTS: Among nasal MRSA isolates, 66.7% were toxigenic. The distribution of genes was as follows: pvl 26.7%, tsst-1 3.3%, and SEs 36.7%. Therefore, the nasal MRSA isolates had a rate of 23.3% multidrug resistance (MDR) pattern to the non-beta-lactams antibiotics. All (100%) clinical MRSA isolates were found to be toxigenic. The distribution of genes was as follows; pvl 10%, tsst-1 6.7%, and SEs 100%. The clinical MRSA isolates had a rate of 60% MDR. CONCLUSIONS: Following detection of pvl, tsst-1, and SEs among nasal and clinical MRSA isolates, and the presence of high antimicrobial resistance, the spread of these strains may be an additional factor contributing to the emergence of community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA. This study is the first to determine the resistance to linezolid and tigecycline in both nasal and clinical MRSA isolates, for the first time in Turkey. All nasal and clinical MRSA isolates were uniformly susceptible to vancomycin and quinupristin-dalfopristin. Our findings show that MRSA infections in Turkey can be empirically treated with vancomycin and quinupristin-dalfopristin based on the lack of demonstrable resistance to these drugs.

Investigation of schizophrenic patients from Istanbul, Turkey for the presence of West Nile virus.

Association of some neurotropic viruses like Borna Disease virus and Herpes virus with schizophrenia is better explained. However, the role of West Nile virus (WNV) infection in schizophrenia is not well documented. Therefore, this study was performed to investigate possible association between schizophrenia and presence of antibodies and WNV RNA in schizophrenic patients. For this, 200 blood samples from patients with schizophrenia and 200 from control groups were collected in Istanbul, Turkey. WNV RNA was not detected in any of the 200 patients and 200 controls analyzed by real-time RT-PCR. One hundred and twelve sera of schizophrenic patients and 162 of controls were analyzed for the presence of IgG antibodies to WNV by a commercial IgG-ELISA (Euroimmun, Germany). Antibodies to WNV were detected in 6 schizophrenic patients and 5 controls. ELISA positive patients had antipsychotic therapy. The difference between groups in terms of seropositivity to WNV was not statistically significant (p = 0.887, p = 0.148). Known symptoms of schizophrenia were observed in these patients, and interestingly majority had close contact to cats in the past and come from agricultural area of Turkey where potential area of mosquitoes and bird habitat. In conclusion, the results of this study show that antibodies to WNV in people do not seem to be associated with schizophrenia. However, detecting antibodies to WNV in schizophrenic patients suggests that WNV infection should be considered in endemic areas as it may play role in psychiatric diseases.

Incidence of H. influenzae in a day-care center.

In this study nasopharyngeal haemophilus influenzae flora of healthy children in a day-care center in istanbul were analyzed. Nasopharyngeal cultures of 168 children between two and five years of age were obtained between December 1, 1992 and April 1, 1993 and investigated. H. influenzae was isolated in 104 cultures. H. influenzae type b (Hib), type f and H. parainfluenzae were found 87 children (51.8%), 15 children (8.9%) and one child (0.6%), respectively, while non-typable H. influenzae was discovered in one child (0.6%). Hib, which is the cause of invasive H. influenzae infection in childhood, was evaluated with respect to age; its incidence was found to be highest in two and three-year-old children, and reduced in children older than four years of age. Although Hib was seen in 518 percent of normal children in the day-care center, invasive Hib disease was not seen in any of those children. Therefore, these children have considered carrier of Hib without clinical manifestations.