Nasopharyngeal pneumococcal carriage in healthy Turkish children after 13-valent conjugated pneumococcal vaccine implementation in the national immunization program.

BACKGROUND: In Turkey, pneumococcal conjugated vaccine (PCV) was introduced to the national immunization program as PCV7 in 2008, and was replaced with PCV13 in 2011. The aims of this study were to investigate the effects of PCV13 on nasopharyngeal pneumococcal carriage (NPC) by determining the serotype distribution, and to identify risk factors for carriage, in healthy Turkish children. METHODS: This prospective study was conducted on 500 healthy children aged 0-13 years between April and November 2014. Nasopharyngeal swab samples were taken, and molecular method for capsular serotyping was performed by multiplex PCR. RESULTS: Of 500 children, 43.4% were unvaccinated with a PCV (7- or 13-valent), 56.6% were vaccinated and The NPC rate was found to be 9.8%. Of 49 positive Streptococcus pneumoniae isolates, 26 (53%) were PCV13 vaccine strains (VSs), and 17 (34.7%) were non-VS. Six isolates (12.2%) were not typeable by the method applied. The most common serotypes detected were serotype 3 (18.3%), serotype 19F (14.2%), serotype 6A/B (8.1%), serotype 11A (8.1%), and serotype 15B (8.1%). The total coverage rate of the PCV13 serotypes was 60.4%. CONCLUSION: A significant decrease in carriage rate was detected within three years after the introduction of PCV13 in Turkey. However, the nasopharyngeal carriage of PCV13 strains was found to be interestingly high.

[Investigation of the Presence of Disinfectant Resistance Genes qacA/B in Nosocomial Methicillin-Resistant Staphylococcus aureus Isolates and Evaluation of Their In Vitro Disinfectant Susceptibilities]. / Hastane Enfeksiyonu Etkeni Olan Metisiline Dirençli Staphylococcus aureus Suslarinda qacA/B Dezenfektan Direnç Genlerinin Varligi ve Dezenfektanlara In Vitro Duyarliliklarinin Arastirilmasi

Development of resistance to disinfectant substances in nosocomial microorganisms is an important problem encountered during disinfectant practices. Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of hospital-acquired infections. Besides being resistant to several antimicrobial agents, MRSA strains can also become resistant to some disinfectant substances. Resistance to disinfectant substances may develop due to the misuse of disinfectants. This may either be due to the frequent use of disinfectant substances or use in lower concentrations than recommended. MRSA strains may harbour the qacA/B disinfectant resistance genes that may cause resistance to quarternary ammonium compounds and some cationic disinfectants. These resistance genes are found in plasmids and are responsible for decreased susceptibility or resistance. In this study, a total of 69 nosocomial MRSA strains isolated from clinical specimens in our hospital were tested for disinfectant activity and the presence of qacA/B disinfectant resistance genes in these isolates was investigated by polymerase chain reaction. We determined whether the presence of these genes caused phenotypic resistance to chlorhexidine and benzalkonium chloride by the use of bactericidal and bacteriostatic tests. For this purpose, the minimum inhibitory concentration (MIC) values of these disinfectants against MRSA isolates were detected by microdilution method with the proposals of CLSI, and bactericidal effects of these disinfectants were also detected by using quantitative suspension test according to EN13727:2003 European Standard. It has been found that 11.6% (8/69) of the isolates harbored qacA/B resistance genes. MIC values for chlorhexidine and benzalkonium chloride were found in the range of 2-8 µg/ml. Although it was observed that MIC values were higher in five of the qacA/B gene positive isolates, statistically significant difference was not found between gene positive and gene negative groups. Both 1% chlorhexidine and 1% benzalkonium chloride were found bactericidal against the isolates including the ones carrying the qacA/B resistance genes. It was concluded that the presence of the qacA/B disinfectant resistance genes did not lead to resistance to the disinfectant substances at the concentrations used in clinical practices. Furthermore, tested disinfectants still exhibited bactericidal activity even with high MIC values.

Hepatitis B virus and hepatitis C virus seroprevalence in the elderly living in nursing homes.

BACKGROUND: : Communal living situations such as nursing homes create a risk for the spread of hepatitis B virus and hepatitis C virus (HCV). The aim of this study was to determine the seroprevalence of hepatitis B virus and HCV in the elderly living in 2 nursing homes in Ankara, Turkey. METHODS: : A total of 227 persons (mean age, 76.11 +/- 8.55 years) participated in this cross-sectional study. All individuals were investigated seroprevalence for hepatitis B surface antigen (HBsAg), anti-HBs immunoglobulin G (IgG), anti-hepatitis B core IgG, and anti-HCV IgG. RESULTS: : Positive seroprevalence was 11.9% for HBsAg, 48.0% for anti-HBs IgG, 25.1% for anti-hepatitis B core IgG, and 2.5% for anti-HCV IgG. Hepatitis B surface antigen positivity was 12.4% in males and 11.5% in females (P > 0.05); and the seroprevalence was 10.4% for those living in nursing homes for 1 year or less and 13.0% for those living in nursing homes for more than 1 year (P > 0.05). CONCLUSIONS: : The fact that nearly half of those living in nursing homes had not encountered hepatitis B infection or had not received hepatitis B vaccination indicates the need for administering hepatitis B vaccines in this group.

[Comparison of agar screening plates and double disk synergy method in detection of extended-spectrum beta-lactamase production]. / Genislemis spektrumlu beta-laktamaz uretiminin saptanmasinda agar tarama plaklari ve çift disk sinerji yönteminin karsilastirilmasi.

In this study, extended-spectrum beta-lactamase (ESBL) production of 83 enteric isolates has been investigated by using a new agar screening method described by Storenburg et al. and double disk synergy (DDS) method. Agar screening method has also been evaluated in terms of presumptive bacterial identification. ESBL production was shown in 15 (18.1%) and 17 (20.5%) of 83 isolates by using DDS method with a distance of 25 and 22-20 mm between antibiotic disks, respectively. Agar screening plates demonstrated 16 (19.3%) ESBL positive isolates and was more sensitive compared to DDS method with 25 mm distance between disks. However, agar screening method gave a successful presumptive bacterial identification in only 10 of 16 ESBL positive isolates. In conclusion, the potential of the new agar screening test in direct identification of ESBL production in clinical samples should be evaluated.

[Detection of cytomegalovirus DNA in immunosuppressed patients using qualitative and quantitative molecular methods]. / Immünsüpresif hastalarda sitomegalovirus DNA'sinin kalitatif ve kantitatif moleküler yöntemlerle arastirilmasi.

In this study, blood samples collected from 101 immunosuppressive patients were investigated for the presence of cytomegalovirus (CMV) DNA, with qualitative nested-polymerase chain reaction (PCR), and leukocytes obtained from these samples with quantitative hybrid capture assay (HCA). CMV-DNA was found positive in 32 (31.7%) and negative in 45 (44.5%) patients with both of the methods, and the agreement between the methods were estimated as 76.2%. The number of samples, which were PCR positive and HCA negative, were 24 (23.7%), while there were no samples which were PCR negative and HCA positive. All of the 56 CMV-DNA positive patients detected by PCR, were found positive for CMV-IgG, and 7 of them were also CMV-IgM positive. As a result, it was concluded that PCR is a practical and reliable method especially for the routine procedures for the investigation of CMV-DNA, however in cases which necessitate the detection of viral load, hybridization may be the preferable method.