Detection of Entamoeba histolytica antigen in stool samples in Mersin, Turkey.

Entameoba histolytica, 1 of the 2 Entamoeba species with similar morphology that infect humans, causes invasive intestinal and extraintestinal diseases, whereas Entamoeba dispar is found commensally and is noninvasive. Because of their morphologic similarity, E. histolytica and E. dispar cannot be differentiated microscopically. The antigens of E. histolytica and E. dispar, however, may be detected by the ELISA method. Previous studies have found that the detection of antigens in the stool is as sensitive and specific as cultures and isoenzyme analyses. Stool samples from 272 patients with diarrhea in the province of Mersin, Turkey, were examined for the presence of Entamoeba species microscopically and for Entamoeba (E. histolytica/E. dispar) antigens using the ELISA method. An E. histolytica-specific ELISA test was used to examine 29 E. histolytica/E. disparpositive samples. Twenty-four (8.82%) of the samples tested positive for E. histolytica/E. dispar by trichrome staining, and 29 (10.6%) of the samples tested positive for E. histolytica/E. dispar by the Entamoeba screening test. Entamoeba histolytica was positive in 21 (7.72%) and E. dispar positive in 8 (2.94%) samples. The detection of true E. histolytica infection is possible with the use of E. histolytica-specific antigen ELISA tests. Thus, real cases of amoebiasis can be detected and treated, and overtreatment of the patients with E. dispar, which is the nonpathogenic species, will be prevented.

Inducible clindamycin resistance in staphylococci isolated from clinical samples.

This study aimed to determine the levels of the macrolides-lincosamides-streptogramins B (MLS(B)) resistance phenotype of Staphylococcus aureus and coagulase-negative staphylococci (CNS) isolates from clinical samples. A total of 521 strains of staphylococci, comprising 230 S. aureus and 291 CNS isolates from various clinical samples, were identified by conventional methods. The double-disc test was applied by placing erythromycin and clindamycin discs on these isolates to investigate the inducible and constitutive MLS(B) resistance phenotypes and MS phenotype. Among the S. aureus strains, 24.3% showed the constitutive and 7.8% the inducible phenotype, while there was no MS phenotype. In the CNS strains, 40.2% showed the constitutive and 14.7% the inducible MLS(B) resistance phenotype, and 18.2% had the MS phenotype. In both S. aureus and CNS strains, the constitutive MLS(B) resistance rate was found to be higher than the rate of inducible resistance. By applying double-disc tests on a routine basis to detect inducible MLS(B) resistance, clindamycin can be effectively used on staphylococcal infections. Additionally, it can be used to survey the MLS(B) resistance of staphylococci strains from specific geographical regions or hospitals.

An outbreak of Pichia ohmeri infection in the paediatric intensive care unit: case reports and review of the literature.

Since the first report in 1998, 10 cases of Pichia ohmeri infection have been reported in the literature. Here we present two new cases of P. ohmeri infection in the paediatric age group. The first case was an 8-month-old male infant, who was admitted with fever, convulsions and altered consciousness. Conservative therapy was started with a presumptive diagnosis of encephalitis. The patient failed to respond to the given treatments and died on the 21st day of hospitalisation. The second case was a 10-year-old male with B-cell acute lymphoblastic leukaemia. He was hospitalised with neutropenic fever. He was discharged after 3 weeks of therapy. In both cases P. ohmeri was identified in blood samples. Growing evidence indicates that P. ohmeri should be added to the lengthening list of opportunistic fungal pathogens that can cause infection in all ages, including infants, and particularly in those who are immunocompromised.