Effect of Laurus nobilis on bacteria and human transforming growth factor-ß1.

OBJECTIVE: In this study, we aimed to determine the phenolic compounds, the antibacterial activity of extract from Laurus nobilis leaves, and its possible effect on transforming growth factor-ß1 expression level in peripheral blood mononuclear cells. METHODS: The phenolic components of Laurus nobilis were identified by the high-performance liquid chromatography method. The antibacterial activity of this extract was determined by disk diffusion and broth microdilution methods. The transforming growth factor-ß1 expression was analyzed using the RT-qPCR method. RESULTS: Epicatechin was found in the highest amount and o-coumaric acid in the lowest amount. The half-maximal inhibitory concentration (IC50) was determined to be 55.17 µg/mL. The zones of inhibition and minimum inhibitory concentration for Staphylococcus aureus, Enterococcus faecalis, and Klebsiella pneumoniae were 15, 14, and 8 mm and 125, 250, and 1000 µg/mL, respectively. The change in transforming growth factor-ß1 expression levels was found to be statistically significant compared with the control groups (p<0.0001). CONCLUSION: Laurus nobilis extract was found to be effective against bacteria and altered the expression level of transforming growth factor-ß1 in peripheral blood mononuclear cells.

Molecular epidemiological investigation of carbapenem resistant Klebsiella pneumoniae isolated from intensive care unit patients of six geographical regions of Turkey.

INTRODUCTION: Klebsiella pneumonia causes serious infections in hospitalized patients. In recent years, carbapenem-resistant infections increased in the world. The molecular epidemiological investigation of carbapenem-resistant K. pneumoniae isolates was aimed in this study. METHODOLOGY: Fifty carbapenem-resistant K. pneumoniae isolates from six geographical regions of Turkey between September 2019-2020 were included in the study. The disk diffusion method was used for the antibiotic susceptibility testing. The microdilution confirmed colistin susceptibility. Genetic diversity was investigated by MLST (Multi-Locus Sequence Typing). RESULTS: The resistance rates were as follows: 49 (98%) for meropenem, 47 (94%) imipenem, 50 (100%) ertapenem, 30 (60%) colistin and amoxicillin-clavulanate, 49 (98%) ceftriaxone, 48 (96%) cefepime, 50 (100%) piperacillin-tazobactam, 47 (94%) ciprofloxacin, 40 (80%) amikacin, 37 (74%) gentamicin. An isolate resistant to colistin by disk diffusion was found as susceptible to microdilution. ST 2096 was the most common (n:16) sequence type by MLST. ST 101 (n:7), ST14 (n:6), ST 147 and ST 15 (n:4), ST391 (n:3), ST 377 and ST16 (n:2), ST22, ST 307, ST 985, ST 336, ST 345, and ST 3681 (n:1) were classified in other isolates. In Istanbul and Ankara ST2096 was common. Among Turkey isolates, the most common clonal complexes (CC) were CC14 (n:26) and CC11 (n = 7). CONCLUSIONS: In Turkey, a polyclonal population of CC14 throughout the country and inter-hospital spread were indicated. The use of molecular typing tools will highlight understanding the transmission dynamics.

Effectiveness of pediatric rotary, rotary and reciprocating instrumentations on bacterial load reduction in primary molars: an ex vivo comparative study.

This study aimed to evaluate the efficacy of intracanal Enterococcus faecalis reduction using pediatric rotary (EndoArt Pedo Kit Blue, EasyInSmile X-Baby and Denco Kids), rotary (ProTaper Next) and reciprocating (WaveOne Gold) file systems through microbiological analyses in primary molars. Seventy-five mandibular primary second molars were selected and divided into five instrumentation groups and a negative control group. After incubation, five roots were used to confirm biofilm formation on the root canals. Before and after instrumentation, bacterial samples were collected. The bacterial load reduction was statistically analyzed by using Kruskall-Wallis and Dunn post hoc tests at a significance level of 0.05. Denco Kids and EndoArt Pedo Kit Blue promoted higher bacterial reduction than EasyInSmile X-Baby systems. There was no difference in bacterial reduction between ProTaper Next rotary file systems and other groups. Among the single-file techniques, instrumentation with the Denco Kids rotary system showed a more significant bacterial load reduction than WaveOne Gold (p < 0.05). All systems used in the study reduced bacterial counts from root canals in primary teeth. Further studies are required to generate more information about the use of pediatric rotary file systems in clinics.

Evaluation of combination therapies with colistin in an experimental mouse pneumonia model induced by carbapenem-resistant Acinetobacter baumannii strain.

The treatment options are limited in Acinetobacter baumannii infections. In this study, the effectiveness of colistin monotherapy and combinations of colistin with different antibiotics were investigated in an experimental pneumonia model induced by carbapenem-resistant A. baumannii strain. Mice in the study were divided into five groups as control (no treatment), colistin monotherapy, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline combinations. The modified experimental surgical pneumonia model of Esposito and Pennington was applied to all groups. The presence of bacteria in blood and lung samples was investigated. Results were compared. In blood cultures, while there was no difference between the control and colistin groups, there was a statistical difference between the control and the combination groups (P = 0.029). When the groups were compared in terms of lung tissue culture positivity, there was a statistical difference between the control group and all treatment groups (colistin, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline) (P = 0.026, P < 0.001, P < 0.001, and P = 0.002, respectively). The number of microorganisms that grew in the lung tissue was found to be statistically significantly lower in all treatment groups in comparison with the control group (P = 0.001). Both monotherapy and combination therapies of colistin were found to be effective in the treatment of carbapenem-resistant A. baumannii pneumonia, but the superiority of combination therapies over colistin monotherapy has not been demonstrated.

Evaluation of monocyte to HDL cholesterol ratio and other inflammatory markers in patients with psoriasis

Abstract Background Psoriasis is a chronic systemic inflammatory disease frequently associated with serious comorbidities. Objectives To investigate the systemic inflammatory burden in psoriasis and to assess the correlation between traditional and novel inflammatory markers and the severity of the disease. Methods This cross-sectional study was conducted on 60 patients with psoriasis vulgaris and 50 healthy volunteers. Data including demographics, Psoriasis Area and Severity Index scores, and laboratory results were analyzed and compared. Results Compared with the control group, the psoriatic patients had significantly higher high sensitive C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, monocyte to high density lipoprotein (HDL) cholesterol ratio, and aspartate aminotransferase levels, and significantly lower HDL cholesterol levels (p < 0.05). No significant difference was found in procalcitonin, lymphocyte, monocyte, hemoglobin, red blood cell distribution width, platelet, mean platelet volume, platelet distribution width, lymphocyte-to-monocyte ratio, anti-cyclic citrullinated peptide, glucose, alanine aminotransaminase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, and LDL cholesterol levels between the two groups (p > 0.05). The Psoriasis Area and Severity Index score was positively correlated with high-sensitivity C-reactive protein, serum amyloid A, and monocyte to HDL cholesterol ratio, and negatively correlated with lymphocyte-to-monocyte ratio (p < 0.05). Study limitations This was a single-center study with relatively limited numbers of patients and controls. Conclusions The data show that high sensitivity C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and monocyte to HDL cholesterol ratio can be used as markers of systemic inflammation in patients with psoriasis. Moreover, high sensitivity C-reactive protein, serum amyloid A, monocyte to HDL cholesterol ratio and lymphocyte-to-monocyte ratio are closely related to the Psoriasis Area and Severity Index score, and they may be regarded as objective indicators in determining the disease severity.

Evaluation of monocyte to HDL cholesterol ratio and other inflammatory markers in patients with psoriasis.

BACKGROUND: Psoriasis is a chronic systemic inflammatory disease frequently associated with serious comorbidities. OBJECTIVES: To investigate the systemic inflammatory burden in psoriasis and to assess the correlation between traditional and novel inflammatory markers and the severity of the disease. METHODS: This cross-sectional study was conducted on 60 patients with psoriasis vulgaris and 50 healthy volunteers. Data including demographics, Psoriasis Area and Severity Index scores, and laboratory results were analyzed and compared. RESULTS: Compared with the control group, the psoriatic patients had significantly higher high sensitive C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, monocyte to high density lipoprotein (HDL) cholesterol ratio, and aspartate aminotransferase levels, and significantly lower HDL cholesterol levels (p < 0.05). No significant difference was found in procalcitonin, lymphocyte, monocyte, hemoglobin, red blood cell distribution width, platelet, mean platelet volume, platelet distribution width, lymphocyte-to-monocyte ratio, anti-cyclic citrullinated peptide, glucose, alanine aminotransaminase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, and LDL cholesterol levels between the two groups (p > 0.05). The Psoriasis Area and Severity Index score was positively correlated with high-sensitivity C-reactive protein, serum amyloid A, and monocyte to HDL cholesterol ratio, and negatively correlated with lymphocyte-to-monocyte ratio (p < 0.05). STUDY LIMITATIONS: This was a single-center study with relatively limited numbers of patients and controls. CONCLUSIONS: The data show that high sensitivity C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and monocyte to HDL cholesterol ratio can be used as markers of systemic inflammation in patients with psoriasis. Moreover, high sensitivity C-reactive protein, serum amyloid A, monocyte to HDL cholesterol ratio and lymphocyte-to-monocyte ratio are closely related to the Psoriasis Area and Severity Index score, and they may be regarded as objective indicators in determining the disease severity.

Evaluation of the Efficacy of Different Cleaning Methods for Orthodontic Thermoplastic Retainers in terms of Bacterial Colonization.

OBJECTIVE: This study investigated the antimicrobial efficacy of three different cleaning methods on Streptococcus mutans (SM) and Lactobacillus (LB) bacteria colonization in vivo. The three different cleaning methods were applied by volunteers on clear vacuum formed retainers (VFRs). METHODS: In this prospective, cross-over study, a total of 21 volunteers were included. All VFRs used by the volunteers were cleaned using three different cleaning methods in a sequence. These methods were peroxide-based cleanser tablets (PBCTs) plus brushing, control (only brushing), and vinegar plus brushing, respectively. The obtained salivary, VFR material, and periodontal data were statistically compared by factorial design repeated measures analysis of variance. RESULTS: The SM and LB bacteria counts on VFRs after using both PBCTs and vinegar were statistically similar (p>0.05), but bacteria counts were statistically lower than the control method (p<0.01). There were no statistically significant differences between the SM and LB bacteria counts in saliva samples taken before and after the application of the cleaning methods (p>0.05). Similarly, there were no significant differences between periodontal data obtained from plaque and bleeding indices at all study times. The periodontal pocket depth gradually decreased in the successively performed cleaning applications (p<0.05). CONCLUSION: The application of PBCTs and vinegar to VFRs at sequential time intervals resulted in similar bacteria counts. The higher LB counts and similarly higher SM counts on the VFR samples indicate that mechanical cleaning only (control method) is not adequate to obtain hygiene. Salivary flora was not correlated with bacteria counts of VFRs.

Evaluation of antimicrobial efficacy of cetrimide and Glycyrrhiza glabra L. extract against Enterococcus faecalis biofilm grown on dentin discs in comparison with NaOCl.

This study aimed to determine the antimicrobial efficacy of NaOCl, cetrimide, and Glycyrrhiza glabra L. extract against Enterococcus faecalis biofilms on dentine discs. Broth microdilution method was used to determine minimal bactericidal concentrations (MBCs) of the agents. A biofilm susceptibility assay was performed using E. faecalis biofilms grown on dentine discs. Minimal bactericidal concentrations (MBCs) of NaOCl (0.5%), cetrimide (0.015%), and G. glabra L. extract (0.25%) were applied for 1, 3, and 5 min, and the mean viable cell counts were recorded and statistically analyzed. There was no significant difference between cetrimide and NaOCl at 1 min (p>0.05). NaOCl was the most effective agent at 3 and 5 min (p<0.05) while G. glabra L. extract was the least (p<0.05). The MBCs of NaOCl, cetrimide, and G. glabra that eliminated the planktonic E. faecalis did not eradicate the biofilms grown on dentin discs.

Determination of in vitro activities of polymyxin B and rifampin in combination with ampicillin/sulbactam or cefoperazone/sulbactam against multidrug-resistant Acinetobacter baumannii by the E-test and checkerboard methods.

The aim of this study was to investigate the in vitro activities of polymyxin B (PB) and rifampin (RIF) in combination with ampicillin/sulbactam (AS) or cefoperazone/sulbactam (CS) against 20 multidrug-resistant Acinetobacter baumannii (MDR-AB) isolates by the checkerboard and E-test methods. Fractional inhibitory concentration index (FICI) values were defined as synergy, FICI ≤ 0.5; additivity, 0.5 < FICI ≤ 1.0, indifference, 1.0 < FICI < 4.0; and antagonism, FICI ≥ 4. Synergistic interaction was detected only for the RIF + AS and RIF + CS combinations. While the most frequently detected interaction type for PB + AS or PB + CS combinations was indifference, some showed antagonistic interactions. The detection rate of synergy was significantly higher by the checkerboard than by the E-test method, and the detection rate of indifference was significantly higher by the E-test than by the checkerboard method for RIF + AS combination (P ≤ 0.0001). In addition, no statistically significant difference was detected between the checkerboard and E-test methods for the detection rates of interaction types for any of the other combinations (P > 0.05), except for PB + CS combination for the detection of additivity (P = 0.018). Owing to the high percentage of synergistic interactions between RIF and AS, we considered this combination as an effective therapeutic option for MDR-AB infections.

Distribution of genes encoding resistance to macrolides, lincosamides and streptogramins among clinical staphylococcal isolates in a Turkish university hospital.

This study investigated the prevalence of genes encoding resistance to macrolides, lincosamides and streptogramins (MLS(B)) among staphylococci in a series of 301 erythromycin-resistant clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci (CoNS). Erythromycin-resistance phenotypes were determined according to Clinical and Laboratory Standards Institute guidelines and specific resistance genes erm(A), erm(B), erm(C), msr(A) and msr(B) were identified using polymerase chain reaction. Two hundred of 301 (66.5%) erythromycin-resistant staphylococcal isolates exhibited resistance to MLS(B) antibiotics. Of these, 127 (63.5%) exhibited a cMLS(B) resistance phenotype (resistant to both erythromycin and clindamycin), whereas 73 (36.5%) expressed the iMLS(B) resistance phenotype (resistant to erythromycin and susceptible to clindamycin). The most prevalent resistance determinants were erm(A) (62%) among S. aureus and erm(C) (30%) among CoNS isolates. Combinations of resistance mechanisms were rarely seen, and occurred most often in oxacillin-resistant isolates. The results of the present study support the idea that there are geographical differences in the prevalence of erythromycin resistance mechanisms among staphylococci, therefore local surveillance studies are important tools for guiding therapy and in the promotion of judicious use of antimicrobial agents.

Microbiological evaluation of octenidine dihydrochloride mouth rinse after 5 days' use in orthodontic patients.

OBJECTIVE: To determine the absolute and relative antibacterial activity of octenidine dihydrochloride (OCT) against total and cariogenic bacteria in saliva samples of patients with fixed orthodontic appliances during 5 days of usage. MATERIALS AND METHODS: The study group consisted of 5 male and 13 female subjects who were selected from patients in the Clinic of Orthodontics. Each patient was given physiologic saline (PS), chlorhexidine gluconate (CHX), polyvinylpyrrolidone-iodine complex (PVP-I), and OCT every morning for 5 days, each separated by a 2-week interval. Total and cariogenic bacteria in saliva samples of orthodontically treated patients with fixed appliances were collected during 5 days of usage. Unstimulated saliva was collected as a baseline sample. Saliva samples were collected at 15 minutes, and on the second, third, and fifth day after rinsing the mouth with any of the solutions for 30 seconds, and bacterial counts were detected. RESULTS: OCT showed an ultimate reduction of total viable oral bacteria, Lactobacillus species, and Streptococcus mutans in vivo. OCT also had a significantly greater inhibitory effect than 0.2% CHX and 7.5% PVP-I, from the beginning of the study until the fifth day after the orthodontic appliances were bonded (P < .1). CONCLUSIONS: OCT compared favorably with respect to CHX and PVP-I complex in orthodontically treated patients with fixed appliances (P

Epidemiologic characterization of nosocomial Acinetobacter baumannii infections in a Turkish university hospital by pulsed-field gel electrophoresis.

BACKGROUND: Although members of the Acinetobacter genus are not commonly part of the human flora, their relatively high prevalence in hospital environment frequently results in colonization of the skin and respiratory tract. OBJECTIVES: The present investigation was carried out to elucidate epidemiologic characteristics of nosocomial Acinetobacter baumannii infections in a teaching hospital. METHODS: Epidemiologic, clinical, and demographic features of the 66 patients with A baumannii infection during a 14-month period were recorded. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method, and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis (PFGE). RESULTS: The incidence of A baumannii infection was especially high in January, April, May, and June 2006. The isolates were most frequently obtained from blood and tracheal aspirates sent from the intensive care unit and neurosurgery ward. Although the most frequently identified predisposing factors were cerebrovascular disease and surgical operation, the main risk factors identified in these patients were catheterization and mechanical ventilation. Genotype analysis of the 66 A baumannii strains by PFGE revealed the circulation of 36 different PFGE types, of which type A (12) and K (17) accounted for 44% of the isolates. We found high clonal relationship (80.3%) among the typed strains. Thirteen antibiotypes were observed. Most of the isolates were multidrug resistant. Resistance to imipenem, meropenem, gentamicin, amikacin, tobramycin, netilmicin, ampicillin-sulbactam, trimethoprim-sulfamethoxazole, piperacillin-tazobactam, cefoperazone-sulbactam, ciprofloxacin, and levofloxacin were found in 44%, 47%, 47%, 84.8%, 21.2%, 3%, 62.1%, 57.6%, 94%, 62.1%, 95.5%, and 95.5% of the isolates, respectively. CONCLUSION: The epidemiologic data obtained suggested that the increase in the number of A baumannii infections in our hospital was caused by the interhospital spread of especially 2 epidemic clones. We determined that clonally related strains can survive for a long time in our hospital and cause nosocomial infections in the predisposed patients.

Short-term relative antibacterial effect of octenidine dihydrochloride on the oral microflora in orthodontically treated patients.

OBJECTIVE: To evaluate the efficacy of common antiseptic mouth rinses and octenidine dihydrochloride (OCT). METHODS: The antibacterial activities of antiseptics against total and cariogenic bacteria (Streptococcus mutans and Lactobacillus species) in saliva were studied in vitro and in vivo. After unstimulated saliva was collected, one of the mouth rinse solutions was applied for 30seconds. Saliva samples were collected 15, 30, 60, and 120min later and evaluated for their bacterial count. RESULTS: OCT had a significantly greater inhibitory effect on the studied bacteria than 0.2% chlorhexidine gluconate (CHX) and 7.5% polyvinylpyrrolidone-iodine complex (PVP-I) from 15min to 120min following the application (p<0.01). The antiseptic efficacy of 0.2% CHX on total bacteria and Lactobacillus species was very similar to the efficacy observed with 7.5% PVP-I mouth solution from 15min up to 120min. Streptococcus mutans was completely inhibited by 0.15mg/ml PVP-I, 0.5mg/ml CHX, and 0.1mg/ml OCT concentrations, while Streptococcus salivarius was inhibited by 0.15mg/ml PVP-I, 2mg/ml CHX, and 0.8mg/ml OCT concentrations. Lactococcus lactis subspecies lactis was inhibited with 0.00313mg/ml OCT, 30mg/ml PVP-I, and 0.0063mg/ml CHX concentrations. CONCLUSIONS: OCT compared favorably with CHX and PVP-I in its antibacterial effects, both in vitro and in vivo (p<0.01).

Macrolide-lincosamide-streptogramin B resistance phenotypes in clinical staphylococcal isolates.

The prevalence of macrolide-lincosamide-streptogramin B (MLSB) resistance as well as the MLSB resistance phenotypes were investigated by the double-disk diffusion test among 532 clinical staphylococci isolates in a Turkish university hospital. The activity of other antimicrobials, including trimethoprim/sulfamethoxazole, telithromycin, quinupristin/dalfopristin, linezolid, gentamicin, chloramphenicol, ciprofloxacin and vancomycin, was also evaluated. Of 532 isolates, 38.5% were resistant to MLSB antibiotics; 63.9% of the resistant isolates exhibited a constitutive phenotype (cMLSB) whereas 36.1% expressed an inducible resistance phenotype (iMLSB). MLSB resistance was more prevalent among coagulase-negative staphylococci (CoNS) strains. Oxacillin-resistant strains exhibited significantly higher MLSB resistance rates compared with oxacillin-susceptible strains (P<0.0001). The most frequently detected resistance phenotype among the total staphylococcal isolates was the constitutive type and this phenotype was more frequently encountered among oxacillin-resistant strains. With the exception of the fully active agents such as vancomycin, linezolid and quinupristin/dalfopristin, the most effective antibiotics were telithromycin and chloramphenicol among all isolates. Susceptibility rates to other antibiotics tested were higher among isolates without MLS(B) resistance than isolates with MLSB resistance. The detection of a considerable rate (43.5%) of iMLSB resistance among erythromycin-resistant/clindamycin-susceptible strains suggests that the true percentage of clindamycin resistance may be underestimated if testing for inducible resistance is not performed.

[The role of anti-cyclic citrullinated peptide (anti-CCP) antibodies in serologic diagnosis and evaluation of disease activity in rheumatoid arthritis]. / Romatoid artritin serolojik tanisinda ve hastalik aktivitesinin degerlendirilmesinde anti-CCP (cyclic citrullinated peptide) antikorlarinin rolü.

Anti-cyclic citrullinated peptide (anti-CCP) antibodies are used as highly specific and sensitive markers in the diagnosis of rheumatoid arthritis (RA), in recent years. The aim of this prospective and cross-sectional study was to measure the levels of anti-CCP and rheumatoid factor (RF) in patients with RA and osteoarthritis, and healthy volunteers to evaluate the specificity and possible diagnostic value of anti-CCP and RF, as well as their correlations with parameters of disease activity. Thirty-four patients with RA (mean age: 53.8 +/- 8.6; 29 female), 32 patients with osteoarthritis (mean age: 53.1 +/- 8.1; 26 female) and 32 healthy controls (mean age: 49.6 +/- 6.7; 24 female) were evaluated between July 2004-July 2005. RA diagnosis was done on the basis of criteria recommended by American College of Rheumatology (ACR). Clinical parameters, including disease activity score (DAS28) and health assessment questionnaire (HAQ) indices for physical capacity were detected for RA patients. As a result, 25 (73.5%) of the patients with RA were found positive for anti-CCP (mean value: 74.6 +/- 64.9 RU/ml), while 24 (70.6%) were positive for RF (mean value: 62.6 +/- 84.8 IU/ml). Serum levels of anti-CCP and RF showed statistically significant increase in patients with RA in comparison with osteoarthritis patients (all were negative for anti-CCP; 6.2% were positive for RF) and healthy controls (all were negative for anti-CCP anf RF) (p < 0.001). Twenty-two of the RA patients (64.7%) yielded positive results for both anti-CCP and RF, while seven (20.6%) were negative for both of the parameters. The sensitivity and specificity of anti-CCP reactivity for RA patients diagnosed based on ACR criteria were detected as 73.5% and 100%, respectively; the corresponding results for RF were 70.6% sensitivity and 96.8% specificity. The mean DAS28 and HAQ scores of RA patients with anti-CCP and RF were higher than the patients without anti-CCP and RF, however these differences were not statistically significant (p > 0.05). Furthermore, a correlation between serum anti-CCP levels and HAQ score was determined, while there was no correlation between DAS28 and anti-CCP levels. In conclusion, antibodies against CCP were thought to be more specific than RF for RA, and the determination of anti-CCP in addition to RF could be helpful in serological diagnosis and monitorization of patients with RA.

Distribution of hepatitis B virus (HBV) genotypes among HBV carriers in Isparta.

BACKGROUND: The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) genotypes in Isparta, Southwest of Turkey, as well as the clinical features and transmission route for patients with HBV infections. METHODS: Patients (n = 135) with HBV infection were included in the study. Epidemiological and clinical data were obtained. HBV genotypes were determined with a preS2 epitope ELISA kit. RESULTS: Although the HBV transmission route remained unidentified in 51.1% of the patients, blood contact was determined as the most common probable transmission route (38.5%). One hundred twenty-four (91.8%) of 135 samples, could be genotyped. One hundred fifteen (85.1%) were genotyped as type D/E, six (4.4%) were genotyped as type A, two (1.4%) were genotyped as type C, and one (0.7%) were genotyped as type F. CONCLUSION: Genotype D/E is determined as the predominant HBV genotype circulating in Isparta, Southwest of Turkey. No relationship between genotypes and disease severity and transmission route has been detected.

Pathogenicity of Blastocystis hominis, a clinical reevaluation.

Blastocystis (B.) hominis was considered to be a member of normal intestinal flora in the past, but in recent years it has been accepted as a very controversial pathogenic protozoan. In this study, 52 individuals whose stool examination revealed B. hominis were evaluated for clinical symptoms. Metronidazole was administered for 2 weeks to the patients infected with B. hominis. After 2 weeks of treatment they were called for a follow-up stool examination. No other bacteriological and parasitological agents were found during stool examination of these patients. The frequency rate of intestinal symptoms was 88.4% in the B. hominis cases. Abdominal pain was the most frequent symptom (76.9%). Diarrhea and distention followed at a rate of 50.0% and 32.6%. Intestinal symptoms may be seen frequently together with the presence of B. hominis and this protozoan may be regarded as an intestinal pathogen, especially when other agents are eliminated.

Adenosine deaminase activity in serum of patients with hepatitis -- a useful tool in monitoring clinical status.

BACKGROUND AND PURPOSE: The evaluation of adenosine deaminase (ADA) activity in sera of patients with hepatitis should be considered a useful tool in the monitoring of their clinical status. In this study, we aimed to determine the relationship between viral load, transaminase levels, and serum ADA levels in hepatitis B virus (HBV)- and hepatitis C virus (HCV)-infected patients. METHODS: Seventy three patients with hepatitis B, 71 patients with hepatitis C and 40 healthy individuals were included. Patients with HBV and HCV infections were classified into 3 groups according to viral load. Serum ADA levels were investigated by colorimetric assays. RESULTS: Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and ADA levels of HBV- and HCV-infected patients were higher than those of the control group. These differences were statistically significant for the levels of all enzymes in HCV-infected patients (p<0.05), and all except AST (p>0.05) in HBV-infected patients. ADA levels of HBV-infected patients with high viral loads were higher than those in HBV-infected patients with intermediate and low viral loads, and the difference was detectably significant between patients with high and intermediate viral loads. Evaluation of HCV-infected patients according to viral load showed no statistically significant relationship between viral load and serum ADA, ALT, and AST levels (p>0.05). HBV- and HCV-infected patients with high ALT and AST levels showed statistically significantly higher levels of ADA than patients with normal ALT and AST levels (p<0.001). CONCLUSIONS: We suggest that serum ADA levels are associated more with the level of serum transaminases than viral load in HBV- and HCV-infected patients. In the treatment of patients with hepatitis, serum ADA levels should be considered a useful tool for the monitoring of liver condition.

Comparison of the BACTEC blood culture system versus conventional methods for culture of normally sterile body fluids.

This study compared the BACTEC blood culture system (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md) with conventional culture methods for recovery and time to detection of significant isolates from normally sterile body fluids. A total of 412 specimens were included in the study. Half of the specimens were inoculated directly into the automated blood culture system. The remaining specimens were centrifuged at 3000 rpm for 10 min and were inoculated onto conventional media. Clinically significant microorganisms were isolated from 41 specimens (10%) by both culture systems; however, for 62 specimens (14.9%), growth was detected only with the BACTEC system. No isolates were detected with only conventional culture methods. A significant difference was noted between the blood culture system and routine culture methods for recovery of pathogenic microorganisms that were from sterile body fluids. The most frequently isolated microorganisms recovered only with the blood culture system were gram-positive cocci; gram-negative bacilli were the most frequently isolated microorganisms that were recovered with both culture methods. Streptococcus pneumoniae, Streptococcus viridans, Aeromonas hydrophila, and Brucella were recovered only with the blood culture system. Furthermore, the mean time to detection of significant pathogens was significantly less with the blood culture system than with conventional media. The BACTEC blood culture system was found to improve the yield of clinically significant isolates from normally sterile body fluids with reduced time to detection; it may be advantageous for isolation of fastidious microorganisms, such as Brucella and S pneumoniae, especially from cerebrospinal and synovial fluid specimens.

Lipid peroxidation level and antioxidant enzyme activities in the blood of patients with acute and chronic fascioliasis.

OBJECTIVE: In this study, we investigated the relationship between fascioliasis and serum malondialdehyde (MDA) levels, superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx) activities. We also investigated whether there are significant differences in MDA levels and antioxidant enzymatic activities between acute and chronic fascioliasis. METHODS: Forty fascioliasis patients who were diagnosed by ES-ELISA positivity were included in this study. The patients were classified as 18 with acute and 22 with chronic fascioliasis. RESULTS: In patients with fascioliasis, levels of MDA were statistically higher and erythrocyte SOD and GPx activities were statistically lower than in healthy controls. MDA levels were found to be higher in patients with acute fascioliasis than in patients with chronic fascioliasis although MDA levels were significantly higher in patients with chronic fascioliasis than in controls. There was no statistically significant difference between the two groups for the antioxidant enzyme activities. CONCLUSION: The results of this study may indicate that fascioliasis produces specific effects on the antioxidant defense mechanisms due to its inflammatory character. Our results also allow us to suggest that oxidative stress has an important role in the pathogenesis of fascioliasis and the persistence of this oxidative stress can be one of the underlying factors in the pathogenesis of the chronic disease.