Synergistic interactions of essential oil components with antibiotics against multidrug-resistant Corynebacterium striatum.

AIM: In this study, it was aimed to examine the antibacterial activity of the essential oil components (EOCs), carvacrol (CAR), cinnamaldehyde (CIN), thymol (TH), alpha pinene (α-PN), eucalyptol (EU), limonene (LIM), and the antibiotics, linezolid (LZD), vancomycin (VAN), gentamicin (GEN), ciprofloxacin (CIP), clindamycin (CLN), and penicillin (PEN) against 50 multidrug resistant Corynebacterium striatum strains, and the synergistic interactions of CAR and CIN with the antibiotics against 10 randomly selected Coryne. striatum strains to explore synergistic interactions to determine if their combined use could enhance antibiotic activity and potentially reduce resistance. METHODS AND RESULTS: The activity of the EOCs and the antibiotics against Coryne. striatum strains isolated from clinical specimens, was examined by broth microdilution method. The synergistic interactions of the EOCs with the antibiotics against 10 randomly selected Coryne. striatum strains were determined by checkerboard method. EOCs, CIN, and CAR and antibiotics, LZD, VAN, GEN, CIP, and CLN were detected to have antibacterial activity against Coryne. striatum strains alone and either synergistic interactions were observed in combinations of the antibiotics with EOCs. CONCLUSIONS: All Coryne. striatum strains were determined to be susceptible to VAN and LZD and resistant to GEN, PEN, CIP, and CLN. Synergistic interactions were observed in all combinations of antibiotics tested with CAR and CIN.

A Dangerous Relationship: A Case of Imported Plasmodium falciparum and Salmonella Typhi Coinfection.

Malaria is a parasitic disease transmitted by the bite of female Anopheles mosquitoes. Although domestic malaria case notification in our country is not seen in World Health Organization records, cases originating from abroad are detected. Travelers to countries where malaria is endemic can become infected with the parasite. In our country, an average of 200-250 cases of malaria originating from abroad are reported every year. Approximately 75% of malaria cases of foreign origin detected in our country are P. falciparum malaria. Malaria and salmonellosis are infections especially seen in developing countries. Although malaria-Salmonella coinfection is rare, early diagnosis and treatment are important in terms of its high mortality rate. Preliminary information and initiation of chemoprophylaxis in travels to regions where the disease is endemic remain important in transmission. In this presentation, a case was examined following a business trip to Africa without any chemoprophylaxis, who applied to a local hospital upon symptoms and was diagnosed with P. falciparum and Salmonella Typhi coinfection but given incomplete treatment. After returning to our country, the patient applying to us with complaints of high fever, chills, nausea, diarrhea and abdominal pain and was discharged with ful recovery.

[Investigation of the Efficacy of Cinnamaldehyde, Cannabidiol and Eravacycline in a Malaria Model]. / Sitma Modelinde Cinnamaldehyde, Cannabidiol ve Eravacycline'in Etkinliginin Arastirilmasi.

In this study, it was aimed to investigate the antimalarial activity of cinnamaldehyde (CIN) and cannabidiol (CBD) which have shown various biological activities such as potent antimicrobial activity and eravacycline (ERA), a new generation tetracycline derivative, in an in vivo malaria model. The cytotoxic activities of the active substances were determined by the MTT method against L929 mouse fibroblasts and their antimalarial activity were determined by the four-day test in an in vivo mouse model. In this study, five groups were formed: the CIN group, the CBD group, the ERA group, the chloroquine group (CQ) and the untreated group (TAG). 2.5 x 107 parasites/mL of P.berghei-infected erythrocyte suspension was administered IP to all mice. The determined doses of active substances were given to the mice by oral gavage in accordance with the four-day test and the parasitemia status in the mice was controlled for 21 days with smear preparations made from the blood taken from the tail end of the mice. The IC50 values, which express the cytotoxic activity values of the active substances were determined as 27.55 µg/mL, 16.40 µM and 48.82 µg/mL for CIN, CBD and ERA, respectively. The mean parasitemia rate in untreated mice was 33% on day nine and all mice died on day 11. On the ninth day, when compared with the TAG group, no parasites were observed in the CIN group, while the average parasitemia was 0.08% in the CBD group and 17.8% in the ERA group. Compared to the mice in the TAG group, the life expectancy of the other groups was prolonged by eight days in the CIN group, 12 days in the CBD group and eight days in the ERA group. It has been determined that all three active subtances tested in this study suppressed the development of Plasmodium parasites in an in vivo mouse model and prolonged the life span of the mice. It is thought that the strong antimalarial activity of CIN and CBD shown in the study and the possible positive effect of ERA on the clinical course can be improved by combining them with the existing and potential antimalarial molecules.

[Comparison of Conventional Methods with Molecular Methods in the Diagnosis of Trichomonas vaginalis and Investigation of Metronidazole Resistance]. / Trichomonas vaginalis'in Tanisinda Konvansiyonel Yöntemlerin Moleküler Yöntemlerle Karsilastirilmasi ve Metronidazol Direncinin Arastirilmasi.

Trichomoniasis is a sexually transmitted parasitic infection caused by Trichomonas vaginalis. In the diagnosis of trichomoniasis, direct microscopy (DM) is preferred, which is a cheap and fast method, although it has low sensitivity. Culture methods, which are accepted as the gold standard, can only be applied in certain centers due to the need for experienced personnel and the ability to get results within 2-7 days, despite their high sensitivity. In this study, it was aimed to compare conventional microscopic and culture methods used in the routine diagnosis of T.vaginalis with polymerase chain reaction (PCR) method and to investigate ntr4 and/or ntr6 gene polymorphism in the nitroreductase gene region, which are thought to be associated with metronidazole resistance in T.vaginalis strains isolated from clinical specimens. Vaginal swab specimens were collected from the posterior fornix of the vagina with two sterile ecuvion sticks during the gynecological examinations of 200 patients who applied to the Balikesir University Health Practice and Research Hospital, Obstetrics and Gynecology Polyclinic between March 2019 and August 2021. The first swab sample was used for direct microscopic examination, Giemsa staining and conventional PCR analysis, while the second swab specimen was taken into trypticase-yeast-extract-maltose (TYM) medium for T.vaginalis culture and followed for eight days at 37 °C. All specimens were screened for the presence of T.vaginalis using primers specific to the ß-tubulin (btub1) gene region and clinical isolates grown in TYM medium were examined for metronidazole resistance using primers specific for the nitroreductase gene region by using conventional PCR. Drug resistance test was also performed for the isolates in which polymorphism associated with metronidazole resistance was detected. Eight (4%) of 200 patient specimens were found positive by both culture/staining and PCR methods. The mean age of the patients included in the study was 39.9, while the mean age of the patients with positive T.vaginalis was 41.8. The most common clinical findings in the patients were foul-smelling vaginal discharge (36%), groin pain (21%), vaginal itching (19%), and burning sensation during urination (18%). In three out of eight T.vaginalis strains isolated from clinical samples, the presence of polymorphism in the ntr6 gene, which is thought to be associated with metronidazole resistance, was demonstrated by PCR. It was observed that three isolates with ntr6 gene polymorphism were phenotypically resistant to metronidazole (MLK= 390 µM). In this study, the fact that three of eight clinical isolates that were resistant to metronidazole by the broth microdilution method and as well as showing ntr6 gene polymorphism supported the thesis that there might be a close relationship between metronidazole resistance and ntr6 gene polymorphism. As a result, the use of culture and molecular methods in the diagnosis of T.vaginalis, in addition to the microscopy method, may contribute to a more accurate laboratory diagnosis of the agent, to detect metronidazole resistance molecularly and phenotypically, to determine metronidazole resistance rates in our country and to update treatment protocols within the framework of these data.

Growth of Trichomonas vaginalis in Basic Media Available in Routine Microbiology Laboratories

Objective: Trichomonas vaginalis is a protozoan parasite with unicellular, flagellate, and anaerobic metabolism. It is the second most prevalent pathogen among sexually transmitted agents after viruses. Microscopic examination, culture, and molecular methods are used in the laboratory diagnosis of T. vaginalis. However, in most routine microbiology laboratories, microscopy is preferred instead of culture and molecular methods for T. vaginalis diagnosis because microscopy is cheaper than other methods. This study aimed to produce T. vaginalis in media that can be detected frequently in microbiology laboratories. Methods: In this study, four media, namely, thioglucholate medium (THIO), brain heart infusion medium (BHI), tryptic soy broth medium (TSB), and Brucella broth medium (BRB) were modified and tested. Trypticase-yeast extract-maltose (TYM) medium was used as a reference medium. Each medium tested was enriched with three different serum additives. T. vaginalis trophozoite at a density of 104 parasites/mL was inoculated into each medium and incubated at 37 °C for 10 days. We determined the number of trophozoites using a hemocytometer, and the viability rates were determined using trypan blue. Results: Trichomonas vaginalis grew extremely well on THIO, BHI, and TSB media but not on BRB media. The time and number of parasites peaked were determined as 100×104 parasites/mL on THIO-ATS and THIO-FCS media on days five and four, respectively, 100×104 parasites/mL on BHI-ATS on day three, 98×104 parasite/mL on BHI-FCS media on day five, 100×104 parasites/mL on TSB-ATS on day four, and 82×104 parasite/mL on TSB-FCS media on day seven. Compared with the reference medium, TYM, T. vaginalis trophozoites survived significantly longer in THIO, BHI, and TSB media. Conclusion: The rich content of THIO, TSB, and BHI media, which are widely available in routine microbiology laboratories, may allow T. vaginalis growth.

[Antibacterial Activity and Synergistic Interaction of Various Essential Oil Components and Antibiotics]. / Çesitli Uçucu Yag Bilesenleri ile Antibiyotiklerin Antibakteriyel Etkinligi ve Sinerjik Etkilesimi.

Inappropriate and uncontrolled use of antibiotics in humans and animals leads to the emergence of multi-resistant bacteria. Before the discovery of antibiotics, plant extracts and essential oils were used for therapeutic purposes. Today, due to increasing antibiotic resistance, many studies are frequently carried out on the antimicrobial activities of natural active substances that can be a source for new drug candidates. The aim of this study was to investigate the antibacterial activity of components such as α-pinene (α-PN), p-cymene (p-CYM), carvacrol (CAR), thymol (TY) and eugenol (EG) found in the essential oils of many plants and their synergistic interaction with antibiotics. In this study, the antibacterial activity of these essential oil components and antibiotics in clinical use such as gentamicin (GEN), tetracycline (TET), tigecycline (TGC) and linezolid (LZD), against Staphylococcus aureus [methicillin resistant S.aureus (MRSA), and methicillin sensitive S.aureus (MSSA)], Escherichia coli and Pseudomonas aeruginosa strains were determined by disc diffusion and microdilution method. In addition, the interaction between the essential oil components and antibiotics was also determined by the checkerboard method. While CAR, TY and EG components showed strong antibacterial activity, the antibacterial activity of αPN and p-CYM was found to be weak. Combinations of α-pinene, carvacrol, thymol and eugenol with gentamicin and tetracycline mostly showed synergistic interactions against all bacteria. In αPN, CAR, TY and EG with GEN and TET, synergistic/partial synergistic interaction was observed against S.aureus strains, while indifferent interaction was detected in E.coli and P.aeruginosa strains. The combination of αPN and p-CYM with TGC showed synergistic interaction against E.coli and P.aeruginosa strains, and additive and indifferent interaction against S.aureus strains. On the other hand, synergistic interaction was observed against all bacterial strains in combinations of TGC and CAR, TY and EG components. Antagonistic interaction was not detected in any of the tested component-antibiotic combinations against the bacteria used in our study. A synergistic interaction between natural bioactive components and commonly used antibiotics may contribute to the effectiveness of antibiotics and components at lower doses, minimizing their potential toxic side effects and reducing treatment costs. However, more research is needed in terms of their pharmacokinetic and toxic properties to evaluate the therapeutic application potential of phytochemicals.

In vitro Cultivation of Plasmodium falciparum.

OBJECTIVE: Plasmodium falciparum is a protozoan parasite that causes many deaths worldwide. It's cultivation in an in vitro culture setting contributes significantly to scientific studies. However, there are no laboratories in Turkey that cultivate P. falciparum in vitro. Hence, the purpose of this study was to cultivate P. falciparum in vitro. METHODS: Five P. falciparum strains were used in our study and were kept frozen in liquid nitrogen tanks. These parasite strains were then thawed in a 37 °C water bath and transferred to the Albumax-complete medium that was previously prepared. After that, the petri dishes were placed in the chamber. For 30 seconds, a special gas mixture containing 5% CO2, 5% O2 and 90% N2 was added into the chamber which was placed in a 37 °C oven and left for incubation for 2 days. At the end of the incubation period, thin smear preparations were prepared from the medium, stained with Giemsa and examined using an immersion lens. RESULTS: Examination of the smears revealed that trophozoite and schizont forms of all P. falciparum isolates were present at a rate of 2% in in vitro culture medium. CONCLUSION: As a result of our study, the in vitro culture of P. falciparum was successfully developed. With this, several projects such as biological and chemical characteristics, pathogenicity, phenotypic and molecular-level drug sensitivities and parasite vaccination studies can be carried out more easily in our country.

The Production of Trypanosoma Brucei Rhodesiense, Cause of African Sleeping Sickness, and Trypanosoma Cruzi, Cause of American Chagas Disease, on Different Medias and Testing a New Media

Objective: Human African trypanosomiasis, also known as sleeping sickness, is a parasitic disease in which Glossina is transmitted by human intervention and Trypanosoma b. rhodosiense and Trypanosoma b. gambiense are the causative agents Production of parasites in axenic cultures provides great advantage in parasite biochemistry, immunological, physiological and molecular studies. In this study, it is aimed to determine the medium which will produce in vigorous amount of Trypanosoma b. rhodosiense and Trypanasoma cruzi and to establish a new medium. Methods: In this study, Trypanosoma b. rhodosiense and Trypanasoma cruzi strains stored in Manisa Celal Bayar University Parasite Bank will be removed from liquid nitrogen tank under suitable conditions, planted in Medium I, Medium II, Medium III and newly developed medium. Reproductive densities of the media will be statistically analyzed on Thoma lamina depending on the time, using the Sidak's multiplequality test. Results: As a result of this study, it has been concluded that the best medium, to produce abundantly Trypanosoma b. rhodosiense and Trypanasoma cruzi strains, to be used in diagnosis and active substance screenings, molecular studies, metabolic analyzes and drug studies is the medium IV. Conclusion: This study is one of the first studies related to the production of Trypanosoma species in Turkey and planned to provide a basis for the studies of African sleeping disease, Chagas disease and their agents.