Investigation of Helicobacter pylori antigen in stool samples of patients with upper gastrointestinal complaints

Abstract Helicobacter pylori infection is usually acquired in early childhood and it can persist throughout life without antibiotic treatment. This study aimed to compare the accuracy of the noninvasive H. pylori Stool Antigen Test-applied on the stool samples with the invasive gold standart Rapid Urease Test-applied on the gastric biopy samples of patients with upper gastrointestinal complaints. After endoscopy, biopsy and stool specimens were taken in 122 patients. The infection was detected with rapid urease test which is accepted as gold standart test. Rapid, one-step H. pylori card test was applied to all patients stool specimens. In this study 106 of the 122 patients (86.8%) were positive for H. pylori infection, while 16 of the 122 patients (13.2%) were negative. H. pylori card test was negative in 13 of the 16 patients and was positive in 98 of the 106. The sensitivity, specifity, positive and negative predictive values were 92.45%, 81.25%, 97.02%, and 61.90%, respectively. H. pylori card test is rapid, easy, noninvasive and inexpensive methods for detection H. pylori infection. This test showed high sensitivity and specificity. Additionally, it may be a good alternative to invasive tests for the detection of H. pylori infections especially in children.

Investigation of Helicobacter pylori antigen in stool samples of patients with upper gastrointestinal complaints.

Helicobacter pylori infection is usually acquired in early childhood and it can persist throughout life without antibiotic treatment. This study aimed to compare the accuracy of the noninvasive H. pylori Stool Antigen Test-applied on the stool samples with the invasive gold standart Rapid Urease Test-applied on the gastric biopy samples of patients with upper gastrointestinal complaints. After endoscopy, biopsy and stool specimens were taken in 122 patients. The infection was detected with rapid urease test which is accepted as gold standart test. Rapid, one-step H. pylori card test was applied to all patients stool specimens. In this study 106 of the 122 patients (86.8%) were positive for H. pylori infection, while 16 of the 122 patients (13.2%) were negative. H. pylori card test was negative in 13 of the 16 patients and was positive in 98 of the 106. The sensitivity, specifity, positive and negative predictive values were 92.45%, 81.25%, 97.02%, and 61.90%, respectively. H. pylori card test is rapid, easy, noninvasive and inexpensive methods for detection H. pylori infection. This test showed high sensitivity and specificity. Additionally, it may be a good alternative to invasive tests for the detection of H. pylori infections especially in children.

Comparison of coagulase-negative staphylococci isolated from blood cultures as a true bacteremia agent and contaminant in terms of slime production and methicillin resistance.

OBJECTIVE: The aim of this study is to determine the species distribution, slime activity, and methicillin resistance of coagulase-negative staphylococci (CoNS) isolated from blood cultures as either contaminants or true bacteremia agents. MATERIALS AND METHODS: In this study, 13.268 blood culture samples sent to our laboratory from various clinics during a two-year period were examined in terms of the presence of CoNS to clarify whether the isolates are true bacteremia agents, as defined by Centers for Disease Control and Prevention (CDC) criteria. The slime activities of true bacteremia agents (58 CoNS strains) and contaminants (50 randomly selected CoNS strains) were investigated by the Christensen method. The methicillin susceptibilities of the strains were determined by the disk diffusion method. RESULTS: Although the frequency of slime production was 39.7% among the true bacteremia CoNS agents, it was 18% in CoNS that were judged to be contaminants (p<0.05). S. epidermidis was the most frequently isolated species for both the true bacteremia agent group (56.9%) and contaminant group (74%). Additionally, S. epidermidis was the bacterium most frequently characterized as slime producing in both groups. The methicillin resistance of slime-producing CoNS was determined to be 82.6% for the true bacteremia agent group and 77.8% for the contaminant group. CONCLUSION: The presence of slime activity in CoNS isolated from blood culture samples is supportive evidence that they are most likely the agents of true bacteremia cases.

[Tularemia seroprevalence in the risky population living in both rural and urban areas of Erzurum]. / Erzurum Merkez ve Kirsalinda Yasayan Riskli Gruplarda Tularemi Seroprevalansi

Tularemia which is a zoonotic infection, caused by Francisella tularensis, has become a re-emerging disease in Turkey. Infection is often transmitted to human by handling animal tissues and products, but it is also possible to acquire the disease from contaminated water or food. Recently several cases and epidemics of tularemia have been reported in the northwest areas of Turkey, particularly in Marmara and West Black Sea regions. Erzurum is a city in Eastern Anatolia Region, Turkey and animal husbandry is the main agricultural activity in that area. However, neither tularemia cases were reported from this province nor seroprevalence studies were performed. In this study we aimed to determine F.tularensis antibody seropositivity in the risky population living at both rural and urban area of Erzurum. Blood samples from 240 volunteer subjects (134 male with mean age: 36.2, age range: 17-75 years and 106 female with mean age: 39.1, age range: 16-77 years) whose occupations were farming and animal husbandry, were included in the study. Serum samples were screened for the presence of F.tularensis antibodies by slide agglutination method (BD, USA) and Serazym ELISA kit (anti-F.tularensis IgG/IgA/IgM, Seramun, Germany). The positive samples with those tests were also retested by microagglutination test (MAT) in National Tularemia Reference Laboratory of Refik Saydam Hygiene Center, using antigen prepared in the same laboratory from the local strain. The serum samples were also searched for the presence of Brucella and Salmonella antibodies in terms of cross-reactivity. Seropositivity was detected in 71 (29.6%) out of 240 subjects by slide agglutination test (SAT), whereas only 5 (2.1%) gave positive result for total antibody by ELISA. Twenty-five of the 71 SAT positive samples yielded F.tularensis antibodies by MAT, of which 21 were between 1/20-1/40 and four were between 1/80-1/160 titers. However, all of the MAT positive samples (n= 25) were found reactive in Brucella and/or Salmonella antibody tests. One of the four MAT positive samples with 1/40 titer and all of the four MAT positive samples with ≥ 1/80 titer yielded positive results in ELISA. Since MAT gave very high cross reactive results, the five subjects (2.1%) found positive with ELISA were evaluated as seropositive for tularemia. Of those subjects (four were female, one was male; age range: 27-38 years), four were the inhabitants of the same village, and one from another neighboring village. All of the seropositive subjects were dealing with raising livestock and two were also farming. No history of contact with rat and wild animals or tick bite were detected, however it was noted that non-chlorinated fountain water has been used in both of these villages. In conclusion, our data emphasized that, populations inhabiting especially in rural area and dealing with farming and stock raising in our region are at risk for tularemia.

Atypical Colony Morphology of Staphylococcus lugdunensis Isolated from a Wound Specimen.

The incidence of infections due to coagulase-negative staphylococci (CoNS) has been steadily increasing in recent years. In this report, we describe an isolate of the CoNS Staphylococcus lugdunensis from a wound specimen with a colony morphology distinct from that of a classical S. lugdunensis colony. Specifically, wrinkled, medium-sized, beta hemolytic, opaque, rough white colonies were detected on blood agar. Catalase-positive, coagulase-negative, gram-positive cocci-yielding such colonies should be suspected of being S. lugdunensis.

Hemolytic activities of the Candida species in liquid medium.

OBJECTIVE: The aim of this study was to evaluate the in vitro hemolytic activities of 107 Candida strains isolated from different clinical samples in liquid medium, and to examine the impact of glucose on this activity. MATERIALS AND METHODS: A total of 107 Candida isolates representing seven species (C. albicans, n=28; C. glabrata, n=23; C. tropicalis, n=17; C. parapsilosis, n=16; C. kefyr, n=14; C. krusei, n=5; C. guilliermondii, n=4) were included in the study. The hemolytic activities of the strains were tested on two different Sabouraud dextrose liquid media (SDB) containing 7% defibrinated human blood, one of which is supplemented with 3% glucose and the other without glucose. Cultures were evaluated at the end of a 48-hour incubation. The hemolysis in the media was detected spectrophotometrically by measuring the amount of released hemoglobin and compared with a standard hemolysate which was prepared prior to testing. The degree of hemolysis (percentage value) by an individual strain was calculated according to the following formula below: (Absorbance of supernatant media at 540 nm / Absorbance of standard hemolysate at 540 nm X 100). RESULTS: In the liquid medium without glucose, strains generally produced hemolysis at low levels. The degree of hemolysis produced by all species increased noticeably in the liquid medium with glucose. Strains of C. albicans and C.kefyr had demonstrated significant hemolytic activity, whereas others had lower activity. C. parapsilosis exerted very little hemolytic activity in the medium with glucose and showed no activity in the medium without glucose. CONCLUSION: The hemolytic activities of most Candida species was found to be higher in the human blood-enriched SDB medium containing 3% additive glucose than in the one free from additives. This result indicates that increased blood glucose concentration may contribute to increased hemolytic activity in Candida species, and it suggests a parallel with possible pathogenesis of Candida in patients with diabetes mellitus.

Aural Myiasis by Wohlfahrtia magnifica: Case Report.

A 5-year-old child living in Erzurum, Turkey, complaining of otalgia, otorrhea and pruritus in the right ear for three days, was examined. Otoscopic examination at the Department of Otorhinolaryngology revealed live maggots in the external auditory canal. Ten maggots were recovered and were identified as third stage larvae of Wohlfahrtia magnifica (Diptera: Sarcophagidae). Local and systemic antibiotic therapies were applied. No pathological findings were present at the follow-up examination after 15 days of therapy.

Evaluation of quinolone resistance in gram negative bacilli isolated from community- and hospital-acquired infections.

OBJECTIVE: Gram negative bacilli are among the most important microbial agents involved in both hospital- and community-acquired infections. The quinolones are preferred antibacterial agents for the treatment of both community- and hospital-acquired urinary tract infections caused by gram negative bacilli because of their strong antibacterial effects, and because they can be administered both orally and parenterally. In this study, it was aimed to determine the sensitivity of gram negative bacteria isolated from both hospital- and community-acquired infections, to quinolones. MATERIALS AND METHODS: Bacterial strains used in this study were isolated from pathologic samples of patients who were treated in different clinics or who were admitted to the polyclinics of Atatürk University Research Hospitals. Susceptibility to ciprofloxacin, levofloxacin, ofloxacin and norfloxacin was assessed for all strains included in the study via the Kirby-Bauer disk diffusion method according to CLSI criteria. RESULTS: Of the 205 strains tested, 116 (56.5%) were from community-acquired infections, and 89 (43.5%) were from hospital-acquired infections. Resistance rates of community-origin strains against ciprofloxacin, ofloxacin and levofloxacin were 25%, whereas they were 26.7% against norfloxacin. Ciprofloxacin was the most effective quinolone (65.2%) against hospital-origin strains. E. coli was the most commonly isolated etiological agent from both community- and hospital-acquired infections. CONCLUSION: In this study, resistance to quinolones was observed for gram negative bacilli isolated from both hospital- and community-acquired infections, with the exception of community-acquired Salmonella and Shigella. Thus, these drugs should not be used empirically in the treatment of infections caused by gram negative bacilli, and susceptibility test results should be considered when planning therapy.

Genotoxic effect of albendazole in pediatric patients with hepatic hydatid disease.

OBJECTIVE: Hydatid disease occurs throughout the world and is treated with both surgery and medical administration of albendazole. Some adverse effects of albendazole are known. However, its genotoxic effect on humans has not been reported yet. In this study, we aimed to investigate the genotoxic effect of albendazole on human lymphocytes in vivo. METHODS: The study involved 14 children (eight males and six females) who had undergone operations for hepatic hydatid disease. The ages of the patients ranged from 6 to 13 years. Genotoxicity of albendazole was evaluated as the frequency of sister chromatid exchange (SCE) and micronucleated cells in the patient's lymphocytes. Prior to and after albendazole treatment, blood samples were obtained from these patients for SCE and micronucleus (MN) studies. SCE and MN frequencies of the patients were measured separately before and after albendazole treatment. RESULTS: All patient SCE values increased significantly after albendazole administration (p<0.001). Similarly, MN frequencies in all the patients increased significantly following albendazole treatment (p<0.001). CONCLUSION: This study revealed that both SCE and MN frequencies are higher after albendazole treatment. The results suggest that albendazole may be genotoxic to human lymphocytes in vivo.

Assessment of antibacterial activity of some topical otological solutions.

OBJECTIVES: Otological solutions have long been used in the treatment of the bacterial and fungal infections of the ear. We investigated antibacterial activity of some otic solutions against the most common bacteria isolated from discharging ears. STUDY DESIGN: Three solutions were used (Castellani's, Burrow's, and 2% salicyl alcohol) for 20 fresh isolates of each of the following organisms: Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa, Escherichia coli, and Enterobacter spp.. The activity of each solution was determined by the size of the zone of inhibition of bacterial growth. RESULTS: The Castellani's solution showed significantly larger average inhibition zones than the other solutions did (p<0.001). CONCLUSION: The Castellani's solution may be considered a good option against bacterial or mixed infections (bacterial and fungal) of the ear.

[Nasal carriage of Staphylococcus aureus in hospital personnel and the normal population and antibiotic resistance of the isolates]. / Hastane personeli ve normal popülasyonda nazal Staphylococcus aureus tasiyiciligi ve izolatlarin antibiyotik direnci.

Nasal carriage of Staphylococcus aureus plays a key role in the epidemiology and pathogenesis of infection, and is a major risk factor for the development of both community-acquired and nosocomial infections. The objective of this study was to investigate the carriage rate of S. aureus in hospital personnel and normal population groups, and to compare the resistance rates of the isolated strains to certain antibiotics. The nasal carriage rates of S.aureus were found to be 27.5% in 262 hospital personnel, and 24.0% in 75 normal healthy subjects (p > 0.05). While methicillin resistant S. aureus rate was 9.7% in hospital personnel, no methicillin resistant strain was detected in the control group (p < 0.05). According to the in-vitro sensitivity test results, resistance rates of meticillin sensitive S. aureus (MSSA) strains isolated from hospital personnel to fusidic acid, erythromycin and clindamycin were as 11%, 18% and 12%, respectively. There were no resistant strains to these antibiotics among MSSA, isolated from normal subjects. In conclusion, the colonization of the resistant strains rather than the frequency of S. aureus colonization is more important in the hospital personnel.

[Sensitivity of methicillin resistant staphylococci to linezolid and some other antimicrobial agents]. / Metisiline dirençli stafilokoklarin linezolid ve diger bazi antimikrobiyal ajanlara duyarliliginin arastirilmasi.

Linezolid is a synthetic antimicrobial agent which was introduced into clinical therapy in the early 2001. It has an inhibitory effect against most of the Gram positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococci. In this study, in-vitro activities of linezolid, teicoplanin, vancomycin, ciprofloxacin, gentamicin, erythromycin, clindamycin, trimethoprim/sulfamethoxazole and rifampicin, were tested against 164 methicillin-resistant Staphylococcus spp. (96 S. aureus and 68 coagulase negative staphylococci) isolated from clinical specimens, by using disk diffusion method. None of the strains were found to be resistant to linezolid, vancomycin and teicoplanin. The resistance rates to other drugs were as follows; 80.5% to ciprofloxacin, 78.0% to gentamicin, 76.8% to erythromycin, 65.5% to clindamycin, 57.3% to trimethoprim/sulfamethoxazole and 41.5% to rifampicin. It was concluded that linezolid can be used as an alternative drug in severe infections caused by methicillin-resistant Staphylococcus spp., especially if the isolate was found to be resistant to teicoplanin or a side effect of vancomycin was observed.

[Erythromycin resistance of group A beta-hemolytic streptococci isolated from patients with upper respiratory tract infections]. / Ust solunum yolu enfeksiyonlarindan izole edilen a grubu beta-hemolitik streptokoklarin eritromisin direnci.

The purpose of this study was to determine the erythromycin resistance of group A beta-hemolytic streptococci (GABHS) isolated from throat cultures. GABHS were isolated from 74 (10.4%) throat cultures of 710 patients with upper respiratory tract infections. Penicillin resistance was observed in none of the strains. Of these strains, 4 (5.4%) were found to be resistant to erythromycin. It was concluded that erythromycin resistance in GABHS, although high in some countries, was not a problem in our country at the moment. So, penicillin G and its alternative erythromycin and other macrolides are still reliable antibiotics for the treatment of GABHS infections.