Should we leave the paper currency? A microbiological examination / ¿Deberíamos dejar de usar los billetes? Análisis microbiológico

OBJECTIVES: Pathogens can be transmitted to banknotes due to the personal unhygienic habits. The aim of study was to find the possible pathogens on the banknotes circulating in the market and also to present their antibacterial resistance and their various virulence factors using genotypic and phenotypic methods. MATERIAL AND METHODS: A total of 150 samples of bank-notes were randomly collected between August 2017 and March 2018. VITEK systems were used for identification and antimicrobial susceptibility testing respectively. Antimicrobial resistance genes (mecA, van, extended-spectrum β-lactamase [ESBL] and carbapenemases) and staphyloccoccal virulence genes (staphyloccoccal enterotoxins [SEs], pvl, and tsst-1) were determined using with real-time PCR. RESULTS: Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Enterococcus spp., Gram-negative enteric bacteria, non-fermentative Gram-negative bacteria and Candida spp. were detected 48%, 54.7%, 56%, 21.3%, 18.7%, and 4%, respectively. Methicillin-resistant S. aureus, vancomycin-resistant enterococci and ESBL producing Gram-negative were found 46.8%, 1.3%, and 28.7%, respectively. Pvl, tsst-1, and SEs genes were found in a 2.8/4.9%, 1.4/1.2%, and 100/ 87.8% of the S. aureus/CoNS strains, respectively. The sea gene was found the most common enterotoxigenic gene. blaTEM, blaSHV, blaCTX-M-2, blaCTX-M-1, blaKPC, and blaOXA-48 were found 55.8%, 46.5%, 41.2%, 18.6%, 18.6%, and 18.6%, respectively in Gram-negative strains. CONCLUSION: These results is very important to highlight hygienic status of paper currencies. This can be considered as an indication that banknotes may contribute to the spread of pathogens and antimicrobial resistance. Therefore, we may need to start using alternative products instead of banknotes

OBJETIVO: Los patógenos se pueden transmitir a los billetes debido a los hábitos antihigiénicos personales. El objetivo del estudio fue buscar los posibles patógenos en los billetes que circulan en el mercado y también observar su resistencia antibacteriana así como sus diversos factores de virulencia utilizando métodos genotípicos y fenotípicos. MATERIAL Y MÉTODOS: Se recogieron al azar un total de 150 muestras de billetes entre agosto de 2017 y marzo de 2018. Se utilizaron los sistemas VITEK para la identificación y las pruebas de sensibilidad a los antimicrobianos, respectivamente. Los genes de resistencia a los antimicrobianos (mecA, van, betalactamasas de espectro ampliado [BLEA] y carbapenemasas) y los genes de virulencia estafilocócica (SE, pvl y tsst -1) se determinaron mediante PCR a tiempo real. RESULTADOS: Se detectó la presencia de cepas de Staphylococcus aureus, Staphylococcus coagulasa negativos (SCN), Enterococcus spp, bacterias gramnegativas, bacterias gramnegativas no fermentativas y Candida spp en un 48%, 54,7%, 56%, 21,3%, 18,7% y 4% de los billetes, respectivamente. Se observó la presencia de S. aureus resistente a meticilina, Enterococcus resistentes a vancomicina y gramnegativos productores de BLEA en un 46,8%, 1,3% y 28,7%, respectivamente. Los genes Pvl, tsst-1 y SE se encontraron en un 2,8/4,9%; 1,4/1,2% y 100/87,8% de las cepas de S. aureus/SCN, respectivamente. El gen sea fue el gen enterotoxigénico más frecuente. Los genes blaTEM, blaSHV, blaCTX-M-2, blaCTX-M-1, blaKPC, y blaOXA-48 se encontraron 55,8%, 46,5%, 41,2%, 18,6%, 18,6%, y 18,6%, respectivamente en cepas gramnegativas. CONCLUSIÓN: Estos resultados son muy importantes para resaltar el estado higiénico de los billetes. De este modo, los billetes pueden contribuir a la propagación de patógenos y de la resistencia a los antimicrobianos. Por lo tanto, es posible que debamos comenzar a utilizar productos alternativos a los billetes

Antimicrobial susceptibility and resistance mechanisms of methicillin resistant Staphylococcus aureus isolated from 12 Hospitals in Turkey.

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important nosocomial pathogens and is also emerging in Turkish hospitals. The aim of this study was to determine the antimicrobial susceptibility profiles of MRSA isolated from Turkish hospitals. MATERIALS AND METHODS: A total of 397 MRSA strains isolated from 12 hospitals in Turkey were included to present study. Antimicrobial susceptibilities were tested using agar dilution method. Presence of ermA, ermB, ermC, msrA, tetM, tetK, linA and aac-aph genes were studied by PCR. RESULTS: All strains were susceptible to vancomycin and linezolid. The susceptibility rates for fusidic acid, lincomycin, erythromycin, tetracyclin, gentamycin, kanamycin, and, ciprofloxacin were 91.9%, 41.1%, 27.2%, 11.8%, 8.5%, 8.3% and 6.8%, respectively. Lincomycin inactivation was positive for 3 isolates. Of 225 erythromycin resistant isolates 48 had ermA, 20 had ermC, and 128 had ermA-C. PCR was negative for 15 strains. Of 3 isolates with lincomycin inactivation one had linA and msrA. Of 358 gentamycin resistant isolates 334 had aac-aph and 24 were negatives. Among 350 tetracyclin resistant isolates 314 had tetM. Of 36 tetM negative isolates 10 had tetK. CONCLUSION: MRSA isolates from Turkish hospitals were multiresistant to antimicrobials. Quinolone and gentamycin resistance levels were high and macrolide and lincosamide resistance were relatively low. Susceptibility rates for fusidic asid were high. Linezolide and vancomycin resistance are not emerged. The most common resistance genes were ermA, tetM and aac-aph. Evolution of antimicrobial susceptibilities and resistance genes profiles of MRSA isolates should be surveyed at regional and national level for accurate treatment of patients and to control dissemination of resistance genes.

[t030 is the most common spa type among methicillin-resistant Staphylococcus aureus strains isolated from Turkish hospitals]. / t030, Türkiye'deki Hastanelerden Izole Edilen Metisiline Dirençli Staphylococcus aureus Izolatlari Arasinda En Yaygin spa Tipidir.

Staphylococcus aureus is one of the most frequent agents causing hospital infections. S.aureus has a great ability to adapt itself to variety of conditions and successful clones can be epidemic and even pandemic by its ability spread from one continent to another. The aims of this study were to detect spa types of 397 methicillin-resistant S.aureus (MRSA) strains isolated from 12 centers in different geographical regions of Turkey from 2006 to 2008, and to investigate their clonality by PFGE and MLST typing. Additionally, 91 MRSA from four of those 12 centers isolated during 2011 were also studied for their spa types. PFGE profiles indicated the presence of a major pulsotype, namely pulsotype A with a rate of 91.4% (363/397), followed by pulsotype B (n= 18, 4.5%) and pulsotype C (n= 11, 2.8%). Among isolates tested 363 (91.4%) were SCCmec type III, 30 (7.6%) were SCCmec type IV. Sequence analysis of representative isolates revealed that ST239 (85.1%) was the most common MLST type followed by two MLST types ST737 (4%), and ST97 (2.8%), both SCCmec type IV. Two isolates were ST80 with SCCmec type IV. Of 397 isolates, 338 (85.1%) were t030, followed by t005 (2.5%) and t632 (2%). Among MRSA isolated during 2011, 64 (70.3%) of 91 were t030, 4 (4.4%) were t005, 2 (2.2%) were t015, and 2 (2.2%) were t1094. Among centers the t030 prevalence of 2006-2008 isolates ranged from 59-100%. The highest t030 prevalence was found in Ankara (100%) and lowest in Trabzon (59%) provinces which are located at central and northestern Anatolia, respectively. In Istanbul province, the prevalence of t030 was 94.5% among 2006-2008 isolates which decreased to 55.5% among 2011 isolates. Also a decrease in t030 rates was observed among samples from Konya and Trabzon but not from Aydin. Our results showed that the most common MRSA clone in Turkey is ST 239-SCCmec type III, t030 which persisted during the six years of the study period. Presence of PVL toxin gene was tested by PCR and 5 (3%) isolates found to be positive, of them two were SCCmec Type IV-ST80 and three were SCCmec Type III-ST239. This study is the largest epidemiological survey ever done in Turkey which showed presence of a hospital Turkish clone TR09 (ST239-SCCmecIII-t030) and a community clone TR10 (ST737-SCCmecIV-t005) largely disseminated in Turkey.

Prospective comparative study of two protocols of antibiotic prophylaxis in percutaneous nephrolithotomy.

BACKGROUND AND PURPOSE: Percutaneous nephrolithotomy (PCNL) is considered to be a clean-contaminated surgical procedure, and all patients are recommended to receive antibiotic prophylaxis before the operation to prevent septic events. The aim of the present study is to prospectively compare two different protocols of antibiotic prophylaxis in PCNL. PATIENTS AND METHODS: Seventy-three patients with preoperative sterile urine were randomized into single-dose or short-course antibiotic prophylaxis groups. Patients in the first group (n=36) were given only a single dose of ceftriaxone during induction of anesthesia, while the second group (n=37) were given an oral third-generation cephalosporin after ceftriaxone until nephrostomy catheter withdrawal. For each patient, urine samples that were taken during initial access into the collecting system, as well as some stone fragments, were sent for culture and sensitivity analysis. Moreover, urine samples of the patients were cultured preceding nephrostomy catheter removal. Occurrence of perioperative infection related events was compared in both groups. RESULTS: The demographic and treatment-related characteristics of both groups were similar. Peroperative urine samples revealed bacteriuria in one and two patients for the first and second groups, respectively. Fever of >38°C (P=0.52) developed in four (11.1%) patients in the first and six (16.2%) patients in the second group. Positive stone cultures developed in eight patients; of those, three (8.3%) were in the first and five (13.5%) were in the second group (P=0.47). The urine sent for culture on the nephrostomy catheter withdrawal day had positive results in three and two patients for the first and second groups (P=0.54). CONCLUSION: Both antibiotic prophylaxis methods were similar in terms of preventing septic complications. Therefore, we think that a single-dose antibiotic prophylaxis protocol may be safely recommended to patients undergoing PCNL.

[Investigation of plasmid-mediated quinolone resistance in Escherichia coli strains]. / Escherichia coli Suslarinda Plazmide Bagli Kinolon Direncinin Arastirilmasi

Quinolones are widely used antimicrobial agents, particularly for the treatment of infections caused by gram-negative bacilli such as E.coli. As a consequence, quinolone resistance has been increasing among this species in recent years. Bacterial resistance to quinolones usually results from mutations in the chromosomal genes which encode topoisomerases and also the expression of efflux pumps and loss of porines contributed to development of quinolone resistance. However, recent studies have shown that the spread and increase of quinolone resistance may be due to the transfer of plasmid-mediated genes. To date, three groups of plasmid-mediated quinolone resistance genes, namely qnr, aac(6')-Ib-cr, and qepA, have been described. The aim of this study was to investigate the presence of plasmid-mediated quinolone resistance genes in E.coli clinical isolates. A total of 112 quinolone-resistant E.coli strains isolated from different clinical specimens (84 urine, 16 blood, 10 wound, 2 bronchoalveolar lavage) of which 78 (69.6%) were extended-spectrum beta-lactamase (ESBL) positive, in Afyon Kocatepe University Hospital, Microbiology Laboratory were included in the study. In the isolates, qnrA, qnrB, qnrS, qnrC, qepA, and aac(6')-1b-cr plasmid genes were analysed by polymerase chain reaction (PCR). After aac(6')- 1b determinant was amplified by PCR, all aac(6')-1b positive amplicons were analyzed by digestion with BseGI restriction enzyme to identify aac(6')-1b-cr variant. It was found that, none of the strains horboured qnrA, qnrB, qnrS, qnrC and qepA genes, however, plasmid-mediated quinolone resistance gene aac(6')-1b-cr was found positive in 59.8% (67/112) of the strains. It was notable that 86.6% (58/67) of those isolates were ESBL producers. The rates of quinolone resistance among E.coli isolates infections were high in our region and an increasing trend has been observed in recent years. Our data indicated that the presence of plasmid- mediated resistance genes such as aac(6')-1b-cr, might have contributed to the high quinolone resistance rates. In conclusion, not only qnr genes but all other plasmid-mediated quinolone resistance genes, should be tested for the detection of plasmid-mediated quinolone resistance and this fact should be taken into consideration when the reservoirs are being searched for.

Could Toxoplasma gondii have any role in Alzheimer disease?

BACKGROUND: Alzheimer disease (AD), a chronic progressive neurodegenerative disorder, has a mainly unknown multifactorial etiology. Neuroinflammatory mechanisms might contribute to the cascade of events leading to neuronal degeneration. Central nervous system infections have been previously suggested as possible etiological agents in the development of sporadic AD. Toxoplasmosis can be associated with various neuropsychiatric disorders. In this study, we aimed to investigate the possible association between toxoplasma infection and AD. METHODS: This study evaluated the serum anti-Toxoplasma gondii IgG levels. It included an age-matched and sex-matched study and control groups that consisted of 34 patients with AD and 37 healthy individuals, respectively. There were no difference between the socio economic states of the patients and control subjects. serecm anti-I-gondi IgG levels were measured by using ELISA. RESULTS: According to the statistical analysis, there were no significant differences among the patients and the control participants with respect to age (68.05±15.98, 62.91±5.89 y, P=0.072; respectively) and sex. The seropositivity rate for anti-T. gondii IgG antibodies among AD patients and control groups were 44.1% and 24.3%, respectively, and there was significant difference between the serum anti-T. gondii IgG levels (P=0.005). CONCLUSIONS: Our findings suggest that toxoplasma infection may be involved in the pathogenetic mechanisms of AD. If confirmed, a positive correlation between toxoplasmosis and AD may lead to new approaches for the management of AD.

Five methods for detection of Helicobacter pylori in the Turkish population.

AIM: To compare culture analysis, Helicobacter pylori (H. pylori) stool antigen (HpSA) test, polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) for H. pylori detection. METHODS: One hundred and thirty-two consecutive adult dyspeptic patients receiving diagnostic endoscopy at the department of gastroenterology were enrolled in this study. Culture and histological examination were performed on biopsy specimens. PCR and FISH tests were applied to histopathological samples. Stool samples that were simultaneously collected were tested for the H. pylori antigen using the HpSA test and bacterial DNA using stool PCR. RESULTS: H. pylori was positively identified by histological examination in 85/132 (64.4%) of the patients, while positive samples were found in 56 (42.4%), 64 (48.5%), 98 (74.2%), 28 (21.2%) and 81 (61.4%) of the patients by culture, HpSA, PCR, stool PCR and FISH methods, respectively. The results of the culture, biopsy PCR, HpSA and FISH tests, with the exception of the stool PCR, were found to correlate with the histological examination as a gold standard. CONCLUSION: The HpSA test is a rapid, simple, and noninvasive test for monitoring therapy. FISH is an accurate, rapid, cost-effective, and easy-to-use test for H. pylori detection.

Evaluation of in vitro activities of tigecycline and various antibiotics against Brucella spp.

Brucellosis is a zoonosis with a worldwide distribution and remains a significant public health problem mainly in the developing world. In this study we evaluated the in vitro activities and synergistic effects of antibiotic combinations against blood culture isolates of Brucella spp. In vitro susceptibilities of 76 blood culture isolates of Brucella melitensis and one blood culture isolate of Brucella abortus to doxycycline, streptomycin, gentamicin, trimethoprim-sulfamethoxazole, moxifloxacin, rifampin, ciprofloxacin, and tigecycline were examined by Etest method. For 37 patients with Brucella spp. isolates (36 B. melitensis, 1 B. abortus), antibiotic combinations used for treatment were identified with those tested in vitro for synergy using Etest method. Trimethoprim-sulfamethoxazole and tigecycline were the most active of the compounds tested with MIC90 value of 0.094 mg/l. Among antibiotic combinations only streptomycin-rifampin combination was synergistic for one Brucella spp. isolate. The other antibiotic combinations revealed antagonistic or indifferent activity. Complete clinical response was achieved in all patients. Further studies are required to determine the correlation between the antimicrobial susceptibility and synergy test results with the clinical course of patients. Brucellosis can be adequately treated with existing regimens in our region.

The probable relation between Toxoplasma gondii and Parkinson's disease.

Parkinson's disease (PD), a chronic progressive neurodegenerative disorder, has a mainly unknown multifactorial etiology. Neuroinflammatory mechanisms might contribute to the cascade of events leading to neuronal degeneration. Toxoplasmosis can be associated with various neuropsychiatric disorders. The most commonly affected central nervous system (CNS) region in toxoplasmosis is the cerebral hemisphere, followed by the basal ganglia, cerebellum and brain stem. Therefore, in this study, we aimed to investigate the possible association between Toxoplasma infection and PD by evaluating the serum anti-Toxoplasma gondii IgG antibodies. There were no difference between the socioeconomic status of the patients and control subjects and magnetic resonance images of the patients were normal. Serum anti-T. gondii IgG levels were measured using ELISA. There was no statistically significant differences among the patients and control subjects with respect to age (66.01+/-12.14 years, 62.42+/-5.93 years, p=0.089; respectively) and gender. The sero-positivity rate for anti-T. gondii IgG antibodies in PD patients and control groups were 42.3 and 22.5%, respectively, and they were statistically significant (p=0.006). These results suggest that Toxoplasma infection may be involved in the pathogenetic mechanisms of PD. If confirmed, this hypothesis would represent a valuable advancement in care of patients with Parkinson's disease.

Increased serum osteoprotegerin levels associated with decreased bone mineral density in familial Mediterranean fever.

Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). The aim of this study was to evaluate the effect of FMF on bone metabolism and to investigate the factors that can influence bone metabolism, such as body mass index (BMI), mutations in Mediterranean fever (MEFV) gene, osteoprotegerin (OPG), leptin and inflammatory cytokines, including interleukin (IL)-1beta, IL-6 and tumor necrosis factor-alpha (TNF-alpha). OPG, a soluble protein produced by osteoblasts, favors increased bone mass. Leptin may influence bone metabolism by acting on differentiated osteoblasts, having anabolic effects on bone. Thirty-one FMF patients in attack-free period (12 females and 19 males; mean age 31.4 +/- 9.3 years) and 18 healthy controls (11 females and 7 males; mean age 34.6 +/- 9.5 years) were compared according to the above parameters. BMD (g/cm(2)) and standard deviation scores (Z-score) were measured at the lumbar spine L(1)-L(4) (BMD-L(1-4)) and proximal femur by dual X-ray absorptiometry. Osteopenia is defined as a Z-score between -1 and -2.5 and osteoporosis is equal or below -2.5. FMF patients showed statistically significant reduction in BMD-L(1-4) and Z-score-L(1-4). Moreover, serum OPG concentration was significantly elevated in FMF patients. In contrast, MEFV gene mutations, leptin and the inflammatory cytokines did not differ between the patient and control groups. In conclusion, BMD was decreased and OPG was increased in our FMF patients. The high OPG levels may reflect a preventive mechanism against bone loss; namely, OPG might protect the FMF patients from excessive osteoporosis.

Conjunctival flora in patients with Parkinson's disease.

PURPOSE: To identify the conjunctival flora in patients with Parkinson's disease (PD) and compare it with the conjunctival flora of healthy subjects. METHODS: One hundred six eyes of 106 patients with PD and 102 eyes of 102 age-matched healthy subjects were included in the study. All subjects had a detailed anterior segment examination, including eye blink rate and conjunctival cultures. Conjunctival cultures were taken with a sterile cotton-tipped dry swab without topical anesthesia. The culture samples were inoculated onto 5% sheep blood agar and chocolate agar, as well as brain heart infusion broth. The bacterial growth was evaluated in a quantitative manner as colony-forming units (CFU). All bacterial isolates were identified, and statistical analyses were performed by chi-square test to determine if there were differences in flora between PD and control groups. RESULTS: Eighty-six (81.1%) of the 106 eyes in patients with PD and 73 (71.5%) of the 102 eyes in control group were found to have positive conjunctival cultures (p = 0.144). Coagulase-negative Staphylococcus was the most commonly isolated bacterial species in both groups, found in 45 (42.4%) and 49 (48%) of eyes in patients with PD and control group, respectively (p = 0.503). Among all bacterial isolates, only Staphylococcus aureus was found to be statistically different between the two groups, noted in 32 (30.1%) and 10 (9.8%) of eyes in patients with PD and control group, respectively (p = 0.001). CONCLUSIONS: Coagulase-negative Staphylococcus, Staphylococcus aureus, and Corynebacterium species were the most commonly isolated bacterial species in the PD group. Among all bacterial isolates, only Staphylococcus aureus was significantly higher in the conjunctival flora of patients with PD than in those in the control group.

In vitro anti-Helicobacter pylori activity of usnic acid.

Eradication of Helicobacter pylori is an important objective in overcoming gastric diseases. Many regimens are currently available but none of them could achieve 100% success in eradication. Medicinal lichen is used in the treatment of gastric ulcer in local folk medicine in Anatolia (Turkey). The present study was performed to assess the in vitro effects of usnic acid from Usnea dasypoga against clinical isolates and standard H. pylori strains and their minimum inhibitory concentrations (MICs). A total of 38 strains was assayed for anti-H. pylori activity. The agar dilution method was used for the determination of usnic acid and clarithromycin resistance.Six (16.2%) clinical isolates were resistant to usnic acid and five (13.5%) were resistant to clarithromycin. Dual susceptibility to usnic acid and clarithromycin rate was detected as very high (97.3%). Usnic acid has a strong and dose-dependent activity against H. pylori strains. The synergism between usnic acid and clarithromycin may be effective in the treatment of H. pylori infection.

Seroprevalence of rubella among Turkish women and children in Afyonkarahisar, Turkey.

The objective of this study was to determine the seroprevalence of rubella virus infection among women and female children/youth (0- 17-years-old) in Afyonkarahisar, Turkey. This study was conducted between November 2005 and February 2006. One thousand four hundred nine serum specimens were studied by the enzyme-linked immunosorbent assay (ELISA) method. Age, educational level, economic and marital status, smoking habit, application or not of measles-mumps-rubella (MMR) vaccination, and previous skin rash of the patients included in the study were questioned and noted. Positive rubella-specific IgG antibodies prevalence was found as 18.5% in girls between 0-1 years of age, 28.6% in girls between 2-6 years of age, 36.8% in girls between 7-17 years of age, and 80.0%, 80.9%, 78.5%, 73.7% and 78.1% in women between 18-20, 21-30, 31-40, 41-50, and 50+ years of age, respectively. There were no statistically significant correlations between immunity to rubella and other sociodemographic characteristics. In conclusion, nearly 20% of women of reproductive age are sensitive to rubella and should be vaccinated. The clear effects of adding MMR to the routine vaccination schedule will be observed in the following years in Turkey.

Serum neopterin levels in patients with HBV infection at various stages.

BACKGROUND/AIMS: Neopterin (NPT) level is elevated in a number of situations in which cellular immunity is active. In the present study, levels of serum NPT were measured in patients who were in different phases of hepatitis B virus (HBV) infection in order to determine if the NPT level can be considered a predictor for the stage of this infection. METHODOLOGY: A total of 120 patients were included in the study, patients were divided equally in four groups; each group consisted of 30 patients. Group I were non-replicative HBV carriers, Group II were immune to HBV, Group III were chronically infected with HBV, and the Group IV were healthy controls. Five ml of blood was drawn from each patient and serum NPT levels were measured by the ELISA technique. RESULTS: Mean NPT levels were found to be 14.80 +/-11.20 nmol/L, 19.73 +/- 18.40 nmol/L, 24.73+/-20.77 nmol/L, and 8.66 +/- 10.03 nmol/L in Group I, II, III and Group IV (the control group) respectively. The mean NPT levels were significantly higher in Group I, II and III than in the control group (Group IV) (p = 0.036, p = 0.010 and p = 0.001 respectively). CONCLUSIONS: Serum levels of NPT are elevated in all the patients in Group I, II and Group III as an indicator of cellular immunity which is activated in different levels. However, an increased level of NPT does not seem to be a sufficient indicator in determining the immunopathogenetic stages of this infection.

[Short communication: determination of hepatitis C virus genotypes by INNO-LIPA and sequence analysis methods]. / Kisa bildiri: hepatit C virus genotiplerinin INNO-LIPA ve sekans analizi yöntemleri ile belirlenmesi.

The detection of genotypes of hepatitis C virus (HCV) which exhibit very high genetic variability, has a great impact for the therapy and follow-up of the chronicity of infections. The aim of this study was to detect the genotypes of HCV strains by using two different methods. Thirty patients (5 hemodialysis patients, 9 chronic hepatitis C patients, 5 blood donors, 1 hospital staff) who were positive for both anti-HCV (Vitros, Ortho-Clinical Diagnostics) and HCV-RNA (Rotorgene, Artus) were included to the study. The serum samples were studied by Inno-LIPA (Inno-LIPA HCV-II, Innogenetics, Belgium) and sequence analysis (9700 Sequence Detection System, and ABI PRISM 310 Genetic Analyzer, Applied Biosystems, USA) methods. For Inno-LIPA, 5'non-coding region (5'NCR) of HCV-RNA was amplified by reverse transcriptase polymerase chain reaction (RT-PCR) and genotyped by line probes. For sequence analysis (SA), NS5B and 5'NCR regions were amplified by RT-PCR, and genotypic variations were assessed by Cycle Sequencing system (Applied Biosystems, USA). As a result, one strain was found as 1a, and 28 strains were found as 1b with both Inno-LIPA and SA methods, however, one strain was genotyped as 1b/3a by Inno-LIPA, but as 1b by SA method. Our data have indicated that the results obtained by Inno-LIPA and sequence analysis methods were in concordance for the detection of HCV genotypes, considering that they have similar sensitivities.

Effect of carbon dioxide pneumoretroperitoneum on bacterial translocation in an experimental retroperitoneoscopy model.

PURPOSE: To evaluate the effect of artificial CO2 pneumoretroperitoneum on bacterial translocation in an experimental retroperitoneoscopy model. MATERIALS AND METHODS: Eighteen adult male New Zealand White rabbits weighing 2.5 to 3 kg were divided into two groups. Group 1 (control group) consisted of 6 rabbits, while the remaining 12 served as the pneumoretroperitoneum group (group 2). In group 1, the left retroperitoneal space was dissected with a 50-mL balloon without CO2 insufflation, and the animals were kept under anesthesia for 3 hours with the balloons inflated. In group 2, after balloon dissection as in group 1, CO2 insufflation was applied at 1 L/min to achieve a pressure of 10 to 12 mm Hg for 3 hours. Afterward, all animals were sacrificed, and samples were taken from the blood, retroperitoneal area, lungs, liver, mesentery, heart, kidneys, ureters, bladder, colon, small intestine, and spleen and carried to the microbiology laboratory in Carry-Blair medium. Bacterial growth was evaluated using standard techniques. RESULTS: All animals survived the experimental procedures. None of the rabbits in the control group demonstrated any bacterial translocation in the sampled tissues. In the pneumoretroperitoneum group, one rabbit was found to have 10(2) colony-forming units of E. coli in the kidney, but this was considered to be the result of contamination, not translocation. CONCLUSION: Carbon dioxide pneumoretroperitoneum does not seem to cause bacteremia or bacterial translocation in this experimental model. Retroperitoneoscopy probably does not create any additional risk of septic complications.

Effect of parasitosis on allergic sensitization in rats sensitized with ovalbumin: interaction between parasitosis and allergic sensitization.

Some helminthic infections, especially nematode infections, may behave as allergens and induce allergic sensitization. In this study, the investigators explored whether infections with Syphacia muris and Aspiculuris tetraptera have any effect on the development of allergen-induced cytokine responses and serum total immunoglobulin E (IgE) levels in ovalbumin (OVA)-sensitized rats. Four groups of male Wistar rats were studied. OVA sensitization was generated in 2 groups of rats; the rats in 1 group were infected and those in the other group were not. On day 21 after sensitization, tumor necrosis factor-alpha, interleukin-10, and total IgE levels in serum samples of rats were measured by enzyme-linked immunosorbent assay. The results showed that average concentrations of tumor necrosis factor-a and interleukin-10 were significantly greater in the group of rats infected with parasites and sensitized to OVA compared with the group uninfected with parasites and sensitized to OVA (P=.043 and P=.046, respectively). Upon comparison of total IgE concentrations, the group of rats infected with parasites and given saline solution showed higher levels compared with the group uninfected with parasites and given saline (P=.004). In conclusion, the investigators were unable to show a protective effect of an existing parasitic infection against the development of allergic sensitization upon exposure to OVA.

Hepatitis B and C virus in West-Central Turkey: seroprevalence in healthy individuals admitted to a university hospital for routine health checks.

BACKGROUND/AIMS: The aim was to determine the seroprevalence rates for hepatitis B virus and hepatitis C virus and the frequency of hepatitis B core antibody seropositivity alone in residents of a city in Turkey. The subjects visited the Family Medicine Outpatient Clinics of a university hospital in Afyon for routine health checks between January 2002 and January 2004. METHODS: A single serum sample was collected from subjects examined. The sera were analyzed by ELISA for hepatitis B surface antigen, hepatitis B surface antibody, anti-HBcIgG and anti-hepatitis C virus. Samples that were HBsAg-positive were also screened for hepatitis B early antigen and antibody. Subjects who were positive for anti-HBcIgG alone were considered to have "isolated anti-HBcIgG positivity". RESULTS: 1320 persons weere screened the rates of positivity for HBsAg, anti- HBs, isolated anti-HBcIgG, and anti-hepatitis C virus were 6.6%, 27.2%, 6.1% and 2.2%, respectively. Eight percent of the 87 HBsAg-positive individuals were HBeAg-positive. Comparison of marker detection rates according to sex and age (younger than 50 years vs 50 years or older) revealed a significantly higher prevalence of HBsAg positivity in males than in females (p=0.02), and a significantly higher prevalence of anti-hepatitis C virus and anti-HBcIgG positivity in the older than in the younger group (p=0.001 and p=0.001, respectively). CONCLUSION: According to our results, the rates of hepatitis B virus and hepatitis C virus seropositivities in our region are similar to those reported in recent studies from other parts of Turkey. But these results cannot be extrapolated to all residents of the Afyon area because a random sampling method was not used for statistical analysis. However, they provide a good reference for future studies because of the large number of cases investigated.

[Evaluation of the level of knowledge of medical secretaries about clinical specimens]. / Tibbi sekreterlerin klinik örnekler hakkindaki bilgi düzeylerinin belirlenmesi.

The rapid development of medical industry in the last 5 years in Turkey led to an increased demand for medical technicians and secretaries. The aim of this study was to evaluate the level of knowledge of students in Occupational School of Medical Documentation and Secretary about the clinical specimens, and to estimate the need for an additional education on clinical specimens. Four hundred and forty eight students from eight universities were participated to this questionnaire survey. Mean age of the participants were 20.4+/-1.66 years and 342 (76.3%) of them were female students. The mean answer rate of students to the questions about clinical specimens was found 3.4+/-1.9% (min-max: 0-10). Correct answer rates were similar for both first and second year students. There was a negative relationship between the educational year and the rate of correct answer, however the correlation was not significant. Additionally, internship period did not have any effect on the level of knowledge. The results of this survey have indicated that the level of knowledge of medical secretaries about clinical specimens was very low. As the roles and responsibilities of medical secretaries in medical industry increases, in order to increase the cost-effectivity, quality and patient satisfaction, the contents of their education programs must be reorganized, and a lecture about clinical specimens should be integrated.

Seroprevalence of human brucellosis in a rural area of Western Anatolia, Turkey.

This study was conducted to determine the seroprevalence of human brucellosis and identify the potential risk factors in a rural area of Western Anatolia, Turkey. A simple random-sampling method was used for identifying 1,052 subjects for the study. Blood samples, collected from all the subjects, were studied following the methods of Rose Bengal slide agglutination and standard tube agglutination tests. One thousand and one samples (95.2%) were seronegative, and 51 (4.8%) were seropositive. There was a statistically significant correlation between seropositivity and age, sex, consuming fresh cheese and cream made from unboiled milk (p values 0.005, 0.019, <0.001, and <0.001 respectively). Seropositivity was not related to educational level (0.270). It is concluded that pasteurization of milk and dairy products and education regarding eating habits must be pursued for eradication of human brucellosis from rural areas. The findings of the study suggest that human brucellosis is still an important public-health problem in the western Anatolia region of Turkey, especially in rural areas.