[Investigation of SARS-CoV-2-Specific Humoral and Cellular Immunity Values in Health Care Workers with COVID-19 Disease and Administered with COVID-19 Vaccine]. / COVID-19 Geçiren ve COVID-19 Asisi Olan Saglik Çalisanlarinda SARS-CoV-2'ye Özgü Humoral ve Hücresel Bagisiklik Degerlerinin Arastirilmasi.

For limiting the coronavirus disease-2019 (COVID-19) pandemic, the effects on both humoral and cellular immune responses due to vaccines and previous infection should be taken into consideration. In some of the studies about the humoral immune response of the virus and different vaccines, it has been suggested that there can be a discordance between cellular and humoral immune responses during COVID-19 infection. The aim of this study was to determine the effects of humoral and cellular immune responses against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antigens in three groups of healthcare workers (HCWs) who were vaccinated with two doses of inactivated virus vaccine (CoronaVac), non-vaccinated and recovered COVID-19 infection and non-infected healthy controls by comparing the variables of gender and age and to examine the relationships between them. In this study, the antibody recognizing the receptor binding domain (RBD) of the spike (S) glycoprotein (IgG-S), nucleocapsid protein (IgG-N) of SARS CoV-2 and Interferon Gamma (IFN-γ) titres were determined among non-infected and vaccinated with two doses of inactivated virus vaccine (IVV) (n= 56, 1st group: 27 men, 29 women), non-vaccinated and COVID-19 convalescents (CG) (n= 41; 2nd group: 21 men, 20 women) and non-vaccinated and non-infected healthy controls (HCG) (n= 23, 3rd group: 10 men, 13 women) in 120 HCWs. Diagnosis of all the participants in COVID-19 CG was confirmed for SARS CoV2 infection with reverse transcription polymerase chain reaction (RT-PCR) test according to manufacturer's instruction (Bio-speedy® SARS CoV-2 Double Gene RT-qPCR, Bioeksen R and D Technologies, Turkey). IgG-S and IgG-N antibody levels were determined quantitatively by Abbott Architect i2000 (Abbott Laboratories, Abbott Park, IL, USA) system. (Qiagen, MD, USA). IFN-γ levels were determined by using the QuantiFERON SARS-CoV-2 Starter Blood Collection Tubes (Qiagen, MD, USA). All statistical data analysis were conducted using SPSS (version 22, IBM Corp., Armonk, NY, USA). Student's independent t-test or Mann-Whitney U test was used for the differences between bivariate groups and Spearman Rank correlation was used to evaluate the monotonic relationship between nonnormally distributed data sets. Spearman rho > 0.7 denotes high, 0.7 > rho > 0.5 moderate and rho > 0.05 was considered as significant. For each of the immunity parameters, there were no significant differences between males and females in the IVV group, as well as in the CG. In neither of the groups age and immunity parameters were found to be highly correlated. All three immunity parameters of males in CG and IVV groups significantly differed from each other. Although humoral immunity parameters of females between CG and IVV groups did not show any significant difference, the IFN-γ titres significantly differed from each other. There were no significant differences in the IgG-S titres between CG and IVV combined gender groups. However, IgG-N and IFN-γ titres significantly differed from each other between CG and IVV groups. Antibody and particularly IFN-γ levels in two dose CoronaVac vaccinated group were less pronounced in comparison to the observed responses in COVID-19 convalescents group, indicating that CoronaVac may induce substantially less robust and persistent cellular and humoral responses than natural SARS-CoV-2 infection.

Clinical Accuracy of Instrument-Read SARS-CoV-2 Antigen Rapid Diagnostic Tests (Ag-IRRDTs).

This systematic review (PROSPERO registration number: CRD42021282476) aims to collect and analyse current evidence on real-world performance based on clinical accuracy of instrument-read rapid antigen diagnostic tests (Ag-IRRDTs) for SARS-CoV-2 identification. We used PRISMA Checklist and searched databases (PubMed, Web of Science Core Collection and FIND) for publications evaluating the accuracy of SARS-CoV-2 Ag-IRRDTs as of 30 September 2021, and included 40 independent clinical studies resulting in 48 Ag-IRRDT datasets with 137,770 samples. Across all datasets, pooled Ag-IRRDT sensitivity was 67.1% (95% CI: 65.9%-68.3%) and specificity was 99.4% with a tight CI. Pooled sensitivity and specificity of SARS-CoV-2 Ag-IRRDTs did not demonstrate a significant superiority over SARS-CoV-2 rapid antigen tests which do not require a reader instrument, even in the case where surveillance and screening datasets were excluded from the analysis. Nevertheless, they provide connectivity advantages and remove operator interface (in results-reading) issues. The lower sensitivity of certain brands of Ag-IRRDTs can be overcome in high prevalence areas with high frequency of testing. New SARS-CoV-2 variants are major concern for current and future diagnostic performance of these tests.

[The Second Shot of CoronaVac Vaccine May Cause Reduction of Antibody Levels in People who Previously had COVID-19]. / CoronaVac Asisinin Ikinci Dozu COVID-19 Geçirmis Kisilerde Antikor Düzeylerinin Düsmesine Neden Olabilir.

The CoronaVac vaccine is an inactivated type two-dose regimen vaccine developed and manufactured by Sinovac Life Sciences Company, in China. It has already been used in China's vaccination program, while 21 other countries (including Indonesia, Turkey and Brazil) also granted emergency use authorization for this vaccine. In Turkey, on January 14, 2021, healthcare workers (HCWs) started to be vaccinated with CoronaVac as the priority group in vaccination. An important question that arose at this time was about how the vaccination schedule would be for people who had previously had Coronavirus disease 2019 (COVID-19). The Centers for Disease Control and Prevention (CDC) recommends that those who have had a previous COVID-19 infection can be vaccinated regardless of their previous infection. CDC guidelines also mention that "…if antibody (Ab) testing was done after the first dose of an mRNA vaccine, the vaccination series should be completed regardless of the Ab test result". It should be noted here that this statement applies particularly to mRNA type vaccines, whereas CoronaVac jab is an inactivated type two-dose regimen vaccine. The aim of this study was to present interim results of our ongoing study to compare the effect of two doses of inactivated CoronaVac vaccine on humoral immunity of people who had previously severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and those people who did not have the infection. In our study, CoronaVac jab containing 600 SU inactivated SARS-CoV-2 antigen was administered as 0.5 ml to 62 HCWs in Yeditepe University Hospital (Istanbul, Turkey), in accordance with the manufacturer's recommendations. Ab levels against spike receptor binding region of SARS-CoV-2 were measured quantitatively. SARS-CoV-2 IgG assay were performed using Abbott Architect i2000 instrument (Abbott Laboratories, Abbott Park, IL, USA). Ab titers were measured before vaccination (Ab0), one month after the first vaccination (Ab1), and one month after the second vaccination (Ab2). The Ab responses of 62 HCWs before and after CoronaVac vaccination were determined. Two groups were created. Group 1 consisted of 18 females and 15 males who were tested as COVID-19 positive, previously. Group 2 consisted of 20 females and 9 males who never had the infection. Minimum, median and maximum Ab0 values of Group1 were 1.6, 180.8 and 5582.6, respectively and Ab1 values were 26.3, 1005.7 and 3923.1; Ab2 values were 202.1, 1119.1 and 2885.9, (in au/mL) respectively. On the other hand, minimum, median and maximum Ab0 values of Group 2 were 0.1, 1.8, and 37.2, Ab1 values were 4.7, 72.7, 470.2, and Ab2 values were 270.3, 746.2 and 5554.1, respectively. In Group 1, 20 of the HCWs showed lower Ab2 titers, while 13 of the HCWs showed higher Ab2 titers than the Ab1 titers. Whereas in Group2 all HCWs had higher Ab2 titers than the Ab1 titers. When the increasing and decreasing Ab2 titers of both groups were evaluated with the 2×2 contingency table and Fisher's exact chi-square test, a statistically significant difference was found between the groups (p<0.001). As a result, we think that a single dose of CoronaVac vaccine similarly to mRNA vaccines can be administered to people who have had COVID-19 due to the possibility that the Ab levels measured after the first dose of vaccine will decrease after the second dose of vaccine.

[Evaluation of a Visually-Read Rapid Antigen Test Kit (SGA V-Chek) for Detection of SARS-CoV-2 Virus]. / SARS-CoV-2 Virüs Tespitinde Görsel Okunan Hizli Antijen Test Kitinin (SGA V-Chek) Degerlendirilmesi.

Although the reverse transcriptase polymerase chain reaction (RT-PCR) method has been accepted as the reference method in the detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA, it requires special laboratory conditions, complicated and expensive laboratory instruments, competent laboratory staff and long testing duration. Antigen testing methods such as enzyme immunoassay, fluorescent antibody and visually-read immunochromatographic rapid antigen detection (RAD) tests eliminated the above mentioned disadvantages of the RT-PCR. The aim of this study was to determine the performance of a RAD test kit (V-Chek, SGA Ltd, Ankara, Turkey). Two paired nasopharyngeal swabs were collected from each patient, and one of them was used for the RAD test, while the other one (different swab) was used to perform the RT-PCR test. SARS CoV-2 Double Gene RT-PCR kit (Bioeksen, Turkey) was used for RNA amplification on the Light Cycler 480 plate-based RT-PCR instrument (Roche, Switzerland). The SARS-CoV-2 double gene RT-PCR kit targeting the SARS-CoV-2 specific N (nucleocapsid) and Orf1ab gene regions was used for RNA amplification. The human RNaseP gene was used for nucleic acid extraction and inhibition control. The shape of the growth curves was examined and the non-sigmoidal curves were recorded as "negative". Sigmoidal curves with cycle threshold (Ct) <38 were evaluated as "positive". The Ct values of all positive results were recorded. V-Chek RAD test kit uses a colloidal gold enhanced double antibody sandwich type antigen test kit. A SARS-CoV-2 positive specimen produces a distinct color band in the test region, formed by the specific antibody-antigen colored conjugate complex. A positive or negative result is indicated by a colored line appearance on the test region. A colored line appears in the control region, independent of the SARS-CoV-2 presence. The result is visually read 10 minutes after the last drop of the sample liquid is dispensed into the sample well. Specificity and sensitivity values were calculated accepting the RT-PCR results as a standard. Agreement between two different techniques was assessed using Cohen's kappa score. 110 patients were enrolled in this study; 34 (30.9 %) of these patients had positive RT-PCR samples, with the mean of Ct values of 25.8 (95% CI= 24.1-27.5), median of Ct values of 26. In our study population, the overall sensitivity was 61.8% (95% CI= 45.4-78.1), and specificity was 100%. Taking RT-PCR as reference, Cohen's kappa score for the antigen test was 0.691. Fisher's exact test was p<0.001. In conclusion, the RAD kit used in the study determined to be useful for the rapid identification of COVID-19 patients. However, a negative result does not eliminate the possibility of COVID-19 infection and should be confirmed by RT-PCR and clinical findings.

New markers: urine xanthine oxidase and myeloperoxidase in the early detection of urinary tract infection.

OBJECTIVES: The aim of this study was to evaluate if xanthine oxidase and myeloperoxidase levels quantitation method may alternate routine culture method, which takes more time in the diagnosis of urinary tract infections. MATERIAL AND METHODS: Five hundred and forty-nine outpatients who had admitted to Clinic Microbiology Laboratory were included in the study. The microorganisms were identified by using VITEK System. The urine specimens that were negative from the quantitative urine culture were used as controls. The activities of MPO and XO in spot urine were measured by spectrophotometric method. RESULTS: Through the urine cultures, 167 bacteria were isolated from 163 urine specimens; 386 cultures yielded no bacterial growth. E. coli was the most frequent pathogen. In infection with E. coli both XO and MPO levels were increased the most. The sensitivity, specificity, positive predictive value, and negative predictive value for XO were 100%, 100%, 100%, and 100%, respectively. These values for MPO were 87%, 100%, 100%, and 94%, respectively. CONCLUSION: These data obtained suggest that urine XO and MPO levels may be new markers in the early detection of UTI.

Serologic and stool antigen assay of Helicobacter pylori infection in hyperemesis gravidarum: which test is useful during early pregnancy?

OBJECTIVE: To investigate the relationship between Helicobacter pylori infection and hyperemesis gravidarum (HG) during early pregnancy by using serologic and stool antigen tests in developing South Anatolia region of Turkey. MATERIALS AND METHODS: A prospective cross-sectional study was performed on 40 pregnant women with HG and 40 asymptomatic controls without gastric problems at 7-12 weeks of gestation. The sociodemographic characteristics were recorded. The presence of H pylori was analyzed in the sera of the study-group patients by serology-specific IgG test in serum and by a stool antigen test in fecal samples. RESULTS: The rates of serology-specific H pylori IgG positivity were 80% (32 of 40) in patients with HG and 35% (14 of 40) in control group. The difference between the two groups was significant [odds ratio: 6.9 (confidence interval: 2.2-22.1); p<0.01]. The rates of H pylori stool antigen test positivity were 87.5% (35 of 40) in patients with HG and 62.5% (25 of 40) in control groups. The difference between the two groups was significant (odds ratio: 4.5, confidence interval: 1.09-18.5); p=0.028. CONCLUSION: Both serology-specific IgG and stool antigen tests seem to be good screening methods to identify H pylori in our pregnant patient population with HG during early pregnancy.

Intraperitoneal EMLA (lidocaine/prilocaine) to prevent abdominal adhesion formation in a rat peritonitis model.

OBJECTIVE: The accelerative effect of EMLA (eutectic mixture of lidocaine 2.5% and prilocaine 2.5%) in the wound healing process is known. We hypothesised that post-operative peritoneal adhesions may be reduced with intra-peritoneal EMLA administration in a model of bacterial peritonitis. STUDY DESIGN: Bacterial peritonitis was induced in 24 rats by cecal ligation and puncture. The rats were randomly assigned to one of four groups. Group 1 (n=6)) received EMLA intraperitoneally, group 2 (n=6) received 2% lidocaine hcl solution intraperitoneally, the third group received one dose (100 mg/kg) of ceftriaxone sodium (Rocephin, Roche, 1 g) intraperitoneally one day after cecal ligation and puncture procedure, and in control group (group 4, n=6), no fluid or medicine was introduced into the abdomens of the rats. All animals were killed 14 days later in order to assess the adhesion score. Tissue antioxidant levels were measured in 1 g tissue samples taken from the abdominal wall. RESULTS: The adhesion score was significantly lower in the EMLA group than in the lidocaine and control groups. The catalase levels were higher in the lidocaine and control groups than in EMLA group. CONCLUSIONS: Intraperitoneal EMLA inhibited the formation of postoperative intra-abdominal adhesions without compromising the wound healing in this bacterial peritonitis rat model. EMLA also decreased the oxidative stress during peritonitis (Tab. 1, Fig. 7, Ref. 27). Full Text (Free, PDF) www.bmj.sk.

Comamonas testosteroni bacteremia in a patient with perforated acute appendicitis. Short communication.

Comamonas testosteroni is an uncommon isolate in the clinical laboratory as a human pathogen. C. testosteroni most commonly emerges in abdominal pathologies especially in perforated appendicitis. In Turkey we report first time a case of bacteremia due to this organism, in a 22-year-old man with perforated acute appendicitis. The organism was shown to be susceptible to routine antibiotics so it was easily eliminated even after having caused a bacteremia.

The comparison of tonsillar surface and core cultures in recurrent tonsillitis.

OBJECTIVE: This study was conducted to investigate whether there is any difference between tonsillar surface and deep tissue cultures in patients who underwent tonsillectomy for recurrent tonsillitis. METHODS: Tonsillar surface and core tonsillar cultures were taken in all patients. The samples were inoculated into 5% sheep blood, chocolate, and MacConkey agar. The bacteria isolated were identified by using standard methods as well as API kits (Bio Mérieux) if necessary. RESULTS: Pathogenic bacteria were isolated in 77 patients, and no pathogenic bacteria were recovered in 39 of 116 patients included in the study. Of these 77 patients, in 52 patients, different types of bacteria were recovered from the surface and deep tissue cultures, whereas in 25 patients, the same types of bacteria were isolated from both surface and deep tissue cultures. The estimated probabilities of tonsillar bacteriology via surface swabs for Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, and group A beta-hemolytic streptococci were 27.2%, 38.4%, 66.6%. and 62.5%, respectively. H influenzae was less frequently predicted by surface culture than others. CONCLUSIONS: We think that the swab cultures taken from the tonsillar surface may not always reveal the real pathogen of the tonsils. In addition, the estimated probability of tonsillar bacteriology by surface swabs varies with the type of the pathogen. If medical therapy is planned on the basis of the tonsillar surface culture, then antibiotics also effective against H influenzae besides the target microorganisms may be chosen.

Prevalance of Chlamydia trochomatis, Ureaplasma urealyticum and Mycoplasma hominis infections in the unexplained infertile women.

OBJECTIVE: To prospectively investigate the prevalence of Chlamydia trachomatis (CT), Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) in the cervical canal and pouch of Douglas in unexplained infertile women and compare it to healthy controls in the Turkish population. MATERIALS AND METHODS: A total of 31 women presenting with a history of infertility [n = 24 (77%) primary infertility, n = 7 (23%) secondary infertility] between 20 and 38 years of age and 31 women willing to have tubal ligation between 30 and 41 years of age were consecutively included into this study. Specimens were taken from intra-abdominal washings and from the cervical canal. CT, MH and UU were detected with polymerase chain reaction (PCR). RESULTS: Results of 62 women were analyzed. None of the participants met the criteria for salpingitis during laparoscopy. The most common infection in the cervical canal in both groups was UU, which was detected in 13 cases of infertile patients and 11 controls (P = 0.602). Cervical chlamydial and mycoplasmic infection was detected in one case each in infertile and control patients. Neither MH nor UU were obtained from the pouch of Douglas in both groups. Only CT was present in peritoneal fluid of an infertile woman who had also a concomitant chlamydial infection in the cervical canal. CONCLUSION: Demonstration of cervical colonization of CT by PCR may be a promising method for the detection of asymptomatic pelvic infection in patients with unexplained infertility. However, screening for MH and UU is not cost-effective due to similar low rates of detection.

Comparison of effects of smoking and smokeless tobacco "Maras powder" use on humoral immune system parameters.

BACKGROUND: The aim of this study is to assess the impacts of "Maras powder" and cigarette smoking on the parameters of the humoral immune system. MATERIAL AND METHODS: One hundred seventy seven subjects were included in the study. The IgA, IgG, IgM, C3 and C4 levels were detected via nephelometric method. RESULTS: In 1.4% of the control group IgM levels were below normal where it was 10.8% and 18.6% in Maras powder group and in cigarette smoking group respectively. The IgM levels of both groups were significantly lower compared to the control group (P < .05). Nonetheless, the IgE levels of Maras powder group and smoking group were found to be remarkably higher compared to the control group (P < .01). CONCLUSION: Effects of Maras powder on humoral immune response were found to be similar to that of smoking.

Bacteremia during open septorhinoplasty.

BACKGROUND: In this study, we aimed at determining the incidence of bacteremia during septoplasty and open septorhinoplasty. METHODS: The study included 60 patients (30 septoplasties and 30 open septorhinoplasties). Preoperative nasal cultures from the nasal cavity and vestibule were taken by using swabs, and blood cultures were obtained from peripheral veins preoperatively, intraoperatively, and postoperatively. Blood cultures were evaluated by using the BACTEC method. RESULTS: Neither the blood cultures taken preoperatively nor those obtained postoperatively was positive for any organisms. On the other hand, although the bacterial growth was observed in only one of the blood cultures (3.3%) taken intraoperatively during septoplasty, it was observed in four blood cultures (13.3%) obtained intraoperatively during open septorhinoplasty. CONCLUSION: Our data indicate that a transient bacteremia occurs during open septorhinoplasty. Although this bacteremia is transient and it has not led to any clinical manifestations in our patients, the possibility of bacteremia during this surgery should be kept in mind and necessary precautions should be taken preoperatively in patients with a high risk of cardiovascular infection.

Intraperitoneal tenoxicam to prevent abdominal adhesion formation in a rat peritonitis model.

PURPOSE: We investigated the effects of intraperitoneal tenoxicam on the development of postoperative intra-abdominal adhesions and oxidative stress in a model of bacterial peritonitis. METHODS: Bacterial peritonitis was induced in 24 rats by cecal ligation and puncture. The rats were randomly assigned to one of three groups. Group 1 (n = 8) received 2 ml saline intraperitoneally, group 2 (n = 8) received 2 ml (0.5 mg/kg) tenoxicam (Oksamen) intraperitoneally, and group 3 (n = 8) was a control, which did not receive any injection. All animals were killed 14 days later so we could assess the adhesion score and measure anastomotic bursting pressures. Tissue antioxidant levels were measured in 1-g tissue samples taken from the abdominal wall. RESULTS: The adhesion score was significantly lower in the tenoxicam group than in the saline and control groups. The anastomotic bursting pressures were higher in the saline and tenoxicam groups than in the control group. The catalase (CAT) levels were higher in the saline and tenoxicam groups than in the control group. The malondialdehyde (MDH) levels were higher in the saline group than in the tenoxicam and control groups. CONCLUSIONS: Intraperitoneal tenoxicam inhibited the formation of postoperative intra-abdominal adhesions without compromising wound healing in this bacterial peritonitis rat model. Tenoxicam also decreased the oxidative stress during peritonitis.

Serum levels of TNF-alpha, IFN-gamma, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis and correlation with disease severity.

Recent progress in the understanding of psoriasis has shown that the regulation of local and systemic cytokines plays an important role in its pathogenesis. The most often used psoriasis score is the psoriasis area and severity index (PASI). A simple laboratory test from a blood sample would be an attractive, patient-independent, and observer-independent marker of disease severity. To this end, we evaluated the association of serum levels of some proinflammatory cytokines in vivo and their correlation with severity of psoriasis. The serum levels of cytokines levels were determined with the use of the ELISA method. All mean values except IL-17 levels of patients were significantly higher than those of controls. There was a significant correlation between serum levels of IFN-gamma, IL-12, IL-17, and IL-18, and severity of the disease. Psoriasis can be described as a T-cell-mediated disease, with a complex role for a variety of cytokines, which has led to the development of new immunomodulatory therapies. In this study, serum TNF-alpha, IFN-gamma, IL-6, IL-8, IL-12, and IL-18 levels were significantly higher in active psoriatic patients than in controls. Furthermore, high levels of IFN-gamma, IL-12, and IL-18 correlated with the clinical severity and activity of psoriasis, and those measurements of serum levels of these cytokines may be objective parameters for the disease severity.

The effects of oxidative stress in urinary tract infection during pregnancy.

The purpose of this study was to determine the effect of urinary tract infection (UTI) on antioxidant systems and lipid peroxidation (LPO) levels during pregnancy. We also investigated if these antioxidant systems and LPO levels differed in each trimester. One hundred forty-three nonpregnant women, as a control group, and 77 pregnant women were included in the study. Urine cultures were performed according to standard techniques. Catalase (CAT), superoxide dismutase (SOD), and LPO levels were measured using a spectrophotometer. UTI was observed in 14 of 77 pregnant women and the isolated microorganisms were Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus. CAT, SOD, and LPO levels were increased in pregnant women compared with nonpregnant women (P<.01). CAT, SOD activities, and LPO levels were increased from the first trimester to the third trimester in pregnancy without UTI. However, CAT and SOD activities were decreased, LPO levels were increased from the first trimester to the third trimester in pregnancy with UTI (P<.01). Pregnancy causes oxidative stress and also UTI during pregnancy may aggravate oxidative stress.

The effects of oxidative stress in urinary tract infection.

We aimed to determine the effects of oxidative stress in urinary tract infection (UTI). One hundred sixty-four urine samples obtained from patients with the prediagnosis of acute UTI admitted to the Faculty of Medicine, Kahramanmaras Sutcu Imam University, were included in this study. Urine cultures were performed according to standard techniques. Urinary isolates were identified by using API ID 32E. The catalase and superoxide dismutase activity and the lipid peroxidation levels known as oxidative stress markers were measured in all urine samples. Thirty-six pathogen microorganisms were identified in positive urine cultures. These microorganisms were as follows: 23 (63.8%) E coli, 5 (13.8%) P mirabilis, 4 (11.1%) K pneumoniae, 2 (5.5%) Candida spp, 1 (2.7%) S saprophyticus, and 1 (2.7%) P aeruginosa. It was observed that lipid peroxidation levels were increased while catalase and superoxide dismutase activities were decreased in positive urine cultures, compared to negative cultures. We conclude that urinary tract infection causes oxidative stress, increases lipid peroxidation level, and leads to insufficiency of antioxidant enzymes.

Urinary tract infection aggravates oxidative stress in diabetic patients.

To investigate the effect of urinary tract infection on oxidative stress in diabetic patients, we measured the activities of antioxidant enzymes such as catalase and superoxide dismutase, and lipid peroxidation levels in urine specimens of type II diabetic patents with urinary tract infection. A total of 69 patients were included into this study: 23 non-diabetic patients with urinary tract infection, 28 patients with diabetes mellitus, and 18 diabetic patients with urinary tract infection. Twenty-five healthy subjects, matched for age, sex, body mass index and smoking status were also included as control. Urine cultures were performed by the standard techniques, and all grown bacteria were identified as Escherichia coli. Antioxidant enzymes and lipid peroxidation levels in urine were measured by spectrophotometric method. In urine samples of diabetic patients with or without urinary tract infection and in urine samples of non-diabetic patients with urinary tract infection, catalase and superoxide dismutase activities were lower and lipid peroxidation levels were higher than those of the healthy subjects (p < 0.05). Diabetic patients without urinary tract infection were similar to non-diabetic patients with urinary tract infection. Decreased antioxidant capacity and the increased levels of lipid peroxidation were profoundly higher in diabetic patients with urinary tract infection. These results indicate that urinary tract infection aggravates the oxidative stress in diabetic patients. Therefore we believe that diabetic patients with urinary tract infection need antioxidant treatment.