Identification and molecular epidemiology of dermatophyte isolates by repetitive-sequence-PCR-based DNA fingerprinting using the DiversiLab system in Turkey.

Dermatophyte species, isolation and identification in clinical samples are still difficult and take a long time. The identification and molecular epidemiology of dermatophytes commonly isolated in a clinical laboratory in Turkey by repetitive sequence-based PCR (rep-PCR) were assessed by comparing the results with those of reference identification. A total of 44 dermatophytes isolated from various clinical specimens of 20 patients with superficial mycoses in Kayseri and 24 patients in Hatay were studied. The identification of dermatophyte isolates was based on the reference identification and rep-PCR using the DiversiLab System (BioMerieux). The genotyping of dermatophyte isolates from different patients was determined by rep-PCR. In the identification of dermatophyte isolates, agreement between rep-PCR and conventional methods was 87.8 % ( 36 of 41). The dermatophyte strains belonged to four clones (A -D) which were determined by the use of rep-PCR. The dermatophyte strains in Clone B, D showed identical patterns with respect to the region. In conclusion, rep-PCR appears to be useful for evaluation of the identification and clonal relationships between Trichophyton rubrum species complex and Trichophyton mentagrophytes species complex isolates. The similarity and diversity of these isolates may be assessed according to different regions by rep-PCR.

Antifungal activity of several root canal sealers against Candida albicans.

OBJECTIVE: The purpose of this in vitro study was to evaluate the antifungal activity of several root canal sealers (iRoot SP, MTA Fillapex and GuttaFlow) against Candida albicans and compare them to that of AH Plus Jet. MATERIALS AND METHODS: A 10 µL fungi in suspension was allowed to directly contact the sealers, which were freshly mixed or allowed to set for 1 or 7 days. Fresh media was then added and survival of fungi was determined by using 10-fold serial dilution and inoculated onto agar plates. After incubation for 48 h, colony-forming units (CFU) were calculated and their log10 values converted. The data were analyzed using ANOVA and Tukey tests (α = 0.05). RESULTS: Freshly mixed AH Plus Jet totally inhibited the growth of fungi and showed the highest antifungal activity. GuttaFlow did not show any significant antifungal activity at all times. Freshly mixed iRoot SP and MTA Fillapex were found to be antifungal. Statistical differences were found between freshly mixed and set samples (p < 0.05) in favor of the former, except GuttaFlow. No statistically significant differences were found among the tested sealers at the 1 and 7-day samples (p > 0.05). CONCLUSIONS: Fresh AH Plus Jet had very potent antifungal activity. All sealers, except GuttaFlow, exhibited antifungal activity when freshly mixed.

Investigation of parvovirus B19 seroprevalence, endothelin-1 synthesis, and nitric oxide levels in the etiology of essential hypertension.

BACKGROUND AND AIMS: Many studies have focused on the role of pathogen infection in hypertension (HT). It has been postulated that increased vascular tonus in HT is basically related to the imbalance between vasodilator, such as nitric oxide (NO), and vasoconstrictor, such as endothelin-1 (ET-1), substances secreted by endothelium. The aim of the present study was to investigate the seroprevalence of human parvovirus B19 (HPV B19) in the etiology of essential HT and the effect of HPV B19 on ET-1 and NO levels in this disorder. MATERIALS AND METHODS: A total of 135 participants were enrolled in the study (90 patient and 45 controls). Antibodies to HPV B19 and ET-1 were measured by enzyme-linked immunosorbent assay method. Nitric oxide levels were calculated according to the Griess reaction. RESULTS: Of the total participants, 27 patients (30%) and 7 control subjects (15.6%) had IgM positive (P = .068), whereas 27 patients (30%) and 14 control subjects (31.1%) had IgG positive (P = .895). There was no statistical difference between patients and control subjects in terms of serum ET-1 and NO levels. CONCLUSIONS: The role of HPV B19 in the etiology of essential HT was not shown in the present study. A larger sample may be needed for the investigation of these relations.

The Role of Topical Thymoquinone in the Treatment of Acute Otitis Externa; an Experimental Study in Rats.

OBJECTIVE: The aim of this experimental study was to compare the dose-related effect of topical thymoquinone (TQ) with other topical agents used in the management of acute otitis externa (AOE) in a rat model. MATERIALS AND METHODS: Forty-eight male Wistar albino rats were divided into six groups each with eight rats per group. Group I was the control group with no external otitis, whereas external otitis were created in the other five groups (study groups). Dexamethasone, 0.1% TQ, 0.4% TQ, ciprofloxacin, and 0.9% saline (NaCl) drops was applied once daily in Groups II-VI, respectively. The treatment was administered regularly for 10 days. Pathologic and microbiologic evaluation were performed. Pathologically, the thicknesses of the stroma and the epithelium in the external auditory canal (EAC) were measured using an occulometer. Edema in the stroma, density of inflammatory cells and blood vessels, presence of fibroblasts, and changes in collagen fibers in the EAC were evaluated in five different areas to obtain the area of highest concentration and classified into four grades (0=no change, 1=mild, 2=moderate, 3=severe). RESULTS: The higher concentration of TQ (0.4%) was more effective than dexamethasone and 0.1% TQ with respect to antibacterial and the anti-inflammatory properties. CONCLUSION: TQ, particularly at a concentration of 0.4%, may be considered for topical application alone in the treatment of AOE, without any requirement for a combined treatment.

Determination of CTX-M beta-lactamase in Escherichia coli strains isolated from clinical samples.

The aim of this study was to determine the ESBL with phenotypic tests and investigate the bla(CTX-M) genes with the PCR method in Escherichia coli strains. The presence of ESBL in E. coli strains was determined with the Vitek 2 automated system. ESBL-positive 100 and ESBL-negative 50 E. coli strains were included in the study. The ESBL disk diffusion screening test (DDST) and the combined disk confirmation tests (CDCT) were performed on these strains and the results of these tests were compared with each other. bla(CTX-M) genes were investigated with the PCR method. The results of CDCT-CAZ-CZC and CDCT-CTX-CTC were found to be consistent in 90% of strains. Those of the automated system, DDST and CDCT-CAZ-CZC were compatible with each other in 83.3% of strains. Also the results of the automated system and CDCT-CTX-CTC were found to be compatible in 83.3% of strains. Based on PCR, bla(CTX-M) genes were found in 67.3% of 150 strains. According to the order of frequency, 46%, 38.7%, 20%, 7.3% of strains were determined to carry groups I, IV, II and III, respectively.

Usefulness of (1→3)ß-D glucan in early diagnosing Pneumocystis jirovecii pneumonia: a case report.

Pneumocystis jirovecii pneumoniae (PJP) may be difficult to diagnose. Since pneumocystis cannot be cultured, the diagnosis of PJP requires microscopic examination to identify pneumocystis from induced sputum or bronchoalveolar lavage (BAL) fluid. In order to evaluate the usefulness of (1→3) beta-D-glucan (BDG) levels in the early diagnosis of PJP, we describe the case of PJP in a 25-year-old male with acute lymphoblastic leukaemia (ALL) admitted to hospital with progressive dyspnea and fever with chills. The patient was not infected with human immunodeficiency virus (HIV). Sputum, blood, and urine cultures were negative; smears for acid-fast bacilli and tests for viral antibodies were both negative. The microbiology study of the BAL with Giemsa and immunofluorescence staining, seven days after admission showed the existence of P. jiroveci in the lungs. Further, one day and five days after admission, (1→3) beta-D-glucan (BDG) levels were very high. The high serum level of BDG considerably decreased after treatment with trimethoprim-sulfamethoxazole (TMP-SMX) and the clinical condition of the patient increasingly improved.

Detection of primary clarithromycin resistance of Helicobacter pylori and association between cagA (+) status and clinical outcome.

Helicobacter pylori was examined in 110 patients (82 (74.5) with gastritis, 18 (16.4) with duodenitis, six (5.5) with duodenal ulcer and gastroesophageal reflux, and four (3.6 %) with normal) with gastrointestinal problems living in rural area, no history of macrolide use, and detected by culture (71.8) or direct detection from gastric biopsies by PCR (82.7 %). Also, cagA gene was identified using PCR and was found positive in 68/91 (74.7 %) strains. The prevalence of clarithromycin-resistant H. pylori was investigated by two methods including PCR-RFLP (7.7 (A2142G 1.1 and A2143G 6.6 %)) and twofold agar dilution (8.9 %) to detect phenotypic and genotypic status simultaneously. Among all the H. pylori positive patients, eight (8.8 %) isolates were found to be resistant to clarithromycin by at least one of the AD and/or PCR-RFLP methods. H. pylori positive rates were significantly correlated with patients' sex, age, and endoscopic findings (p = 0.040, <0.001 and <0.001, respectively). There were no differences in gender or endoscopic findings related to cagA (+) and cagA (-) patients. The gene of cagA was not significantly helpful in predicting the clinical outcome of H. pylori infection alone. In conclusion, we revealed that there was a low prevalence of primer clarithromycin resistance in patients living in rural area with no history of macrolide use. The prevalence of mutant strains among the macrolide-resistant H. pylori varies even geographically between close provinces.

The investigation of total PSA, free PSA, and free/total PSA ratio in patients with liver cirrhosis patients according to Child-Pugh score.

OBJECTIVE: To investigate the total prostate-specific antigen (tPSA), free PSA (fPSA), and free/total PSA (fPSA/tPSA) ratio in patients with liver cirrhosis (LC) according to the severity of hepatic insufficiency. METHODS: Eighty-two male patients with LC were studied. The severity of liver disease was categorized by Child-Pugh score (Child-Pugh A, B, and C). Forty-two age-matched healthy subjects were used as a control group. The tPSA, fPSA, fPSA/tPSA ratio, total prostate volume (TPV), total testosterone (TT), and total protein (TP) were measured. The LC group was compared with the control group in terms of these parameters. In addition, intra-comparison and inter-comparison was made between all the Child-Pugh groups and normal subjects, in terms of these parameters. RESULTS: The tPSA and fPSA levels in LC cases, Child-Pugh A, Child-Pugh B, and Child-Pugh C groups were significantly decreased compared with the control group. The ratio of fPSA/tPSA in the LC subjects and Child-Pugh A groups significantly increased compared with the control group. TT, TP levels, and TPV in patients with LC were significantly lower compared with the control group and the results were significantly correlated with the Child-Pugh score. CONCLUSION: The present study reveals that tPSA and fPSA were decreased in patients with LC in comparison to healthy subjects in terms of 3 mechanisms. First, it might be due to shrunken prostatic volume. Second, it also resulted in decreased levels of testosterone because of the abnormality of hypothalamic-pituitary-testicular axis. Third, it might be the diminished serum protein level in the composition of the PSA.

[Investigating Demodex folliculorum in patients with urological cancer]. / Ürolojik Kanserli Hastalarda Demodex folliculorum Arastirilmasi

OBJECTIVE: In this study, it was aimed to determine frequency of Demodex folliculorum infestation in patients with urological cancers. METHODS: This study evaluated 49 patients with urological cancers; 31 sex-matched healthy individuals as a control group were included in the study between March 2011 and April 2012 at the Hospital of Mustafa Kemal University, School of Medicine, Urology Clinic. The demographic characteristics of the patients were recorded. Samples from the perineal region of the subjects were taken by standard method of superficial skin biopsy and evaluated by microscopy. Presence of five or more Demodex sp. in a cm < sup > 2 < /sup > was considered as positive. RESULTS: Mean age was found to be 60.2±18.6 years. D. folliculorum was found to be positive in 11 (22.4%) of the patients with cancer and in 1 (3.2%) of the subjects in the control group. It was found that D. folliculorum frequency was significantly higher in the cancer group compared to the control group. No significant difference was found among the cancer groups in terms of D. folliculorum detection. In the cancer group, mean age was significantly higher in D. folliculorum positive patients than negative ones. CONCLUSION: It should be kept in mind that D. folliculorum incidence may increase in immunosuppressive states, such as cancer.

[The investigation of Toxoplasma gondii seropositivity in women in the Kayseri province]. / Kayseri'de kadinlarda Toxoplasma gondii seropozitifliginin arastirilmasi.

Toxoplasmosis is a parasitic disease caused by a protozoon, Toxoplasma gondii. Its prevalence varies according to geographical status, age, eating habits and life style. The aim of this study was to determine seropositivity of Toxoplasma gondii in women who presented at the Kayseri Obstetric and Children Hospital. Anti-Toxoplasma IgG and IgM antibodies were investigated with the microparticle enzyme immunoassay (MEIA) method in sera of 2235 women from August 2005 to December 2008. It was found that Toxoplasma seropositivity was 33.42% and that increases in the seropositivity rate is statistically significant in regard to the increase in age (p<0.05).