[Show abstract][Hide abstract] ABSTRACT: Group A rotaviruses are the most common causative agent of acute gastroenteritis among children less than 5 years of age throughout the world. This sentinel surveillance study was aimed to obtain baseline data on the rotavirus G and P genotypes across Turkey before the introduction of a universal rotavirus vaccination program.
Rotavirus antigen-positive samples were collected from 2102 children less than 5 years of age who attended hospitals participating in the Turkish Rotavirus Surveillance Network. Rotavirus antigen was detected in the laboratories of participating hospitals by commercial serological tests such as latex agglutination, immunochromatographic test or enzyme immunoassay. Rotavirus G and P genotypes were determined by reverse transcription polymerase chain reaction (RT-PCR) using consensus primers detecting the VP7 and VP4 genes, followed by semi-nested type-specific multiplex PCR.
RT-PCR found rotavirus RNA in 1644 (78.2%) of the samples tested. The highest rate of rotavirus positivity (38.7%) was observed among children in the 13 to 24 month age group, followed by children in the age group of 25 to 36 months (28.3%). A total of eight different G types, six different P types, and 42 different G-P combinations were obtained. Four common G types (G1, G2, G3, and G9) and two common P types (P and P) accounted for 95.1% and 98.8% of the strains, respectively. G9P was the most common G/P combination found in 40.5% of the strains followed by G1P (21.6%), G2P (9.3%), G2P (6.5%), G3P (3.5%), and finally, G4P (3.4%). These six common genotypes included 83.7% of the strains tested in this study. The rate of uncommon genotypes was 14%.
The majority of the strains analyzed belonged to the G1-G4 and G9 genotypes, suggesting high coverage of current rotavirus vaccines. This study also demonstrates a dramatic increase in G9 genotype across the country.
PLoS ONE 12/2014; 9(12):e113674. DOI:10.1371/journal.pone.0113674 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: The aim of the study was to compare C-reactive protein (CRP), procalcitonin (PCT) and serum amyloid A (SAA) levels in children with bacterial infection. Material and Methods: In this prospective study, 120 pediatric patients who were hospitalized with bacterial infection in the Uludag University Medical Faculty Pediatric Clinic between June 2009 and June 2011 were included. Patients were evaluated in 5 groups as sepsis, pneumonia, meningitis, pyelonephritis and other infection groups. Before initiating the antimicrobial therapy, blood samples for whole blood count, blood culture, CRP, PCT and SAA were obtained from children with bacterial infection. This procedure was repeated three times at 48 h, 7 and 10 days. Whole blood count was performed using an automated counter, Cell Dyn 3700 (Abbott Diagnostics Division, Santa Clara, CA, USA). CRP and SAA were determined by an immunonephelometric method using BN II device (Dade Behring Marburg GMBH, Marburg, Germany). PCT was measured by Enzyme- Linked Fluorescent Assay (VIDAS PCT; Brahm Diagnostica GMBH, Lyon, France). Results: Of the patients, 66 (55%) were male and 54 (45%) were female. The median age was 37.5 months (1-209). PCT levels of the sepsis group was significantly higher than those of the pneumonia and other infection groups (respectively, p=0.001, p=0.003). SAA levels were higher in the meningitis group than those of the pneumonia group (p=0.007). When patients were divided into two groups as invasive bacterial infection group and localised bacterial infection group; PCT levels were found significantly higher in the invasive bacterial infection group than those of the localised bacterial infection group. Also, percentage change of PCT at the 48th hour, 7 and 10 days was determined as significantly higher in the invasive bacterial infection group than that of the localised bacterial infection group. Conclusion: In this study, PCT seems to be a more valuable parameter in diagnosing invasive bacterial infections.
[Show abstract][Hide abstract] ABSTRACT: Extrinsic contamination of propofol is thought to be a source of postoperative sepsis. Researchers studied growth of Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Candida albicans in propofol, thiopental and in a 1:1 propofol-thiopental mixture. All microorganisms were taken from standard stock cultures. Half of the samples were incubated at 20°C and the rest were stored at 4°C for 120 h. Growth of microorganisms in each solution was compared by counting the number of the Colony-Forming Units (CFUs) at 0, 3, 6, 24, 72 and 120 h Propofol supported the growth of all four microorganims at both temperatures. In contrast, thiopental and the 1:1 propofol-thiopental mixture exhibited markedly bactericidal properties onE. coli, C. albicans and P. aeruginosa and bacteriostatic effect on S. aureus.
Journal of Animal and Veterinary Advances 10/2010; 9(10):1432-1435. DOI:10.3923/javaa.2010.1432.1435 · 0.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of life-threatening human infections. The clinical impact of MRSA is mounting, not only due to the ever-increasing prevalence but also due to the occurrence of new, community-acquired MRSA strains. The aim of this prospective, multi-centre study was to determine the prevalence and genetic relatedness of clinically relevant MRSA isolates, in Turkey.
During a 1-year period, data from 20 successive patients with invasive S. aureus infections were collected from eight university hospitals, geographically distributed over the six main regions of Turkey. Among these S. aureus isolates, the genetic association of MRSA isolates was investigated by pulsed-field gel electrophoresis (PFGE) and spa typing. A selected number of isolates were also analyzed by multilocus sequence typing (MLST). Furthermore, Panton Valentine leucocidin (PVL) genes were examined.
In this study, the rate of methicillin resistance in S. aureus in patients with apparent infections (sepsis, meningitis, lung abscess or septic arthritis) ranged from 12 to 75% within the seven participating centres. Typing by pulsed-field gel electrophoresis and spa typing revealed the presence of 22 closely related genotypes. According to the PFGE and spa typing results, 53 out of 54 MRSA isolates were closely related. These isolates were of spa type t030 or a related spa type, contain an SCC mec type III element and belong to sequence type ST239. None of the isolates contained the PVL genes.
Despite the broad surface area of Turkey, a single predominant clone of ST239 circulates in hospitals in different regions and only few new types of MRSA were introduced over the past years. These results place Turkey in the epicenter of ST239 prevalence.
The Journal of infection 05/2009; 58(6):433-8. DOI:10.1016/j.jinf.2009.04.006 · 4.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The prevalence of Shigella and Salmonella in a range of foodstuffs purchased from supermarkets and smaller units in Bursa province (Turkey) over a 7-month period between December 2004 and June 2005 was evaluated. In total 416 food samples composed from chicken parts, minced meats, ready-to-eat salads, raw vegetables and raw milks were analysed. Among the samples only one chicken thigh sample (0.24%) was found to be contaminated with Salmonella whereas Shigella was not isolated from any samples. Isolated Salmonella strain was serotyped as Salmonella enterica subsp. enterica serovar Infantis (S. Infantis) and displayed multidrug resistance to several antibiotics including streptomycin, tetracycline, sulphonamides, trimethoprim, trimethoprim-sulphamethoxazole and nalidixic acid. Decreased susceptibility to ciprofloxacin (MIC 0.38 mg/L by E-test) was also determined. The present study revealed that despite low contamination rate, foodstuffs particularly chicken parts could be a potential vehicle for foodborne infections and implementation of preventive measures and consumer food safety education efforts are needed.
Food Control 11/2008; 19(11-19):1059-1063. DOI:10.1016/j.foodcont.2007.11.004 · 2.81 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of the present paper was to determine the rate of culture-proven nosocomial infections and evaluate the episodes of nosocomial Gram-positive (GP) bacterial infections in pediatric patients.
The data of children with positive culture, who were diagnosed as having nosocomial infection on the Centers for Disease Control and Prevention criteria, were examined and only the patients with nosocomial GP bacterial infections were included in the study.
Between January 1997 and January 2004 a total of 836 episodes of nosocomial GP bacterial infections were observed. The most frequently seen nosocomial GP bacterial infections were primary bloodstream infections (BSI; 43%), ventriculoperitoneal shunt infections (18%), and nosocomial pneumonias (11%). Coagulase-negative staphylococci (CONS; 46%) were the most common nosocomial GP bacteria isolated, followed by Staphylococcus aureus (33%). Methicillin resistance rates for CONS and S. aureus were 85% and 25.2%; respectively. The mortality rate was 4% of all children with nosocomial GP bacterial infections in the present study.
In the present patients primary BSI were the most common nosocomial GP bacterial infections and CONS were the most frequent GP pathogen isolated. Antimicrobial resistance in GP isolates is an increasing problem.
Pediatrics International 01/2008; 49(6):875-82. DOI:10.1111/j.1442-200X.2007.02485.x · 0.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Molecular epidemiologic surveillance of Acinetobacter baumannii by polymerase chain reaction-randomly amplified polymorphic DNA analysis in a university hospital for 3 consecutive study periods.
Twelve different Acinetobacter baumannii genotypes (A-L) were detected. Although only 2 genotypes were detected during the first period and genotype A appeared to be the most common genotype, genotype D was included in these genotypes during the second study period. Genotype A completely disappeared during the third period. Although the presence of genotype C and the genotype D continued during the third period, 9 new genotypes were detected during this period. Genotype A appeared to be the most common genotype in the hospital (detected in 19 different clinics). The distribution of genotypes in clinical samples correlated with patient traffic between them. Some genotypes were found in both clinical and environmental samples. Seventeen different antibiotypes were detected, according to antibiotic susceptibility profiles.
Environmental contamination, airborne transmission, patient transfer, and cross-contamination play important roles in epidemics caused by A. baumannii in our hospital. The distribution of genotypes can change over time, so antibiotyping is not appropriate for the epidemiological analysis of A. baumanii infection.
Infection Control and Hospital Epidemiology 05/2006; 27(4):404-8. DOI:10.1086/503349 · 4.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We measured plasma concentrations of TGF-beta 1 in patients with obstructive ureteral calculi and compared them with the plasma concentrations of healthy volunteers. The present study was a prospective study containing a homogenous group of patients with unilateral ureteral obstruction (UUO). The study consisted of patients with ureteral stones less than 7 mm in diameter that caused mild to moderate obstruction. All patients were referred by the emergency department of our hospital and examined between April 2003 and April 2004. The presence and characteristics of both stone and obstruction were determined by plain abdominal x-ray and gray-scale ultrasonography (US). Blood samples were collected from both patients and control individuals on admission and 1 week after conservative follow-up. The plasma TGF-beta 1 concentration was determined using a quantitative sandwich enzyme immunoassay specific for TGF-beta 1. There were 35 patients with 20 women and 15 men (average age 26.8+/-5.9 years), and 15 volunteers in the control group, with nine women and six men (average age 24.2+/-4.5 years). Average stone size was 5.6 mm+/-1.2 mm (range 3.5-7) for the patient group. US showed the presence of mild hydronephrosis in 24 and moderate hydronephrosis in 11 patients. Plasma concentrations of TGF-beta 1 in patients with ureteral obstruction (1,117+/-5.8 ng/ml, range 36-2,442 ng/ml) were significantly higher than those in the healthy control group (32+/-4 ng/ml) on admission (P<0.001). There was a significant increase in TGF-beta 1 plasma concentrations in the patient group (33,525+/-6.8 ng/ml, range 1,107-73,288 ng/ml) after 1 week follow-up (P<0.001). Ureteral obstruction increases plasma TGF-beta 1 concentrations in patients with ureteral stones as in UUO models in animal studies. A concomitant treatment with an anti-fibrotic agent may reduce the incidence of renal injury during obstruction.
Urological Research 12/2005; 33(6):465-9. DOI:10.1007/s00240-005-0509-z · 1.39 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: : Brucellar spondylitis is one of the most serious complications of brucellosis. It should be considered in patients who have back pain and neurologic disorders as well as systemic symptoms and findings in or from endemic areas such as Turkey. This report describes important features of the disease.
: Twenty-five patients with brucellar spondylitis were retrospectively evaluated in terms of their clinical, laboratory, and radiologic features and their response to different treatment regimens.
: The most common symptoms of brucellar spondylitis were back pain, fever, and sweating. Rose Bengal tests were positive in all of these patients. Brucella species was isolated from blood cultures of 8 (32%) patients. Magnetic resonance imaging (MRI) showed that the lumbar segment was the most frequently involved region. Different combination regimens including 2 or 3 antibiotics were used. Combination of tetracycline (especially doxycycline) and streptomycin was the most widely used therapy regimen. Trimethoprim-sulfamethoxazole, ciprofloxacin, ofloxacin, and rifampin were also included in some combination therapies. In this series, the mean duration of antimicrobial therapy was 130 +/- 45.6 days (range, 77-281 days), and 92% of patients received therapy for >/= 90 days. There were no mortalities in this study.
: Brucellar spondylitis should be considered in patients with back pain and neurologic disorders as well as systemic symptoms and findings in endemic areas. MR imaging is recommended in suspected cases. The patients can be treated effectively treated with appropriate antibiotic combinations. Follow up is important because relapses can occur.
[Show abstract][Hide abstract] ABSTRACT: Some automated systems used in clinical microbiology laboratories are able to detect products responsible for antimicrobial resistance. In this study, 626 isolates (436 Escherichia coli, 134 Klebsiella pneumoniae and 56 Klebsiella oxytoca strains) were examined for the presumptive detection of extended-spectrum beta-lactamase (ESBL) production by 2 methods: the Sceptor system (BD, Sparks, MD, USA) and the E-test. ESBL production was detected in 26 E. coli strains (5.96%), 60 K. pneumoniae strains (44.77%) and 15 K. oxytoca strains (26.78%) by ceftazidime/ceftazidime-clavulanate E-test. Using the E-test, ESBL production was detected in 25 of 201 E. coli strains (12.43%), 55 of 75 K. pneumoniae (73.33%) and 14 of 27 K. oxytoca strains (51.85%) that were alerted as ESBL-producing strains by the Sceptor system. ESBL positivity was detected in 1 E. coli, 5 K. pneumoniae and 1 K. oxytoca strains, that were not warned as being ESBL producers by the Sceptor system. These data suggest that clinical microbiology laboratories should not only rely on these rapid automated systems but also use another method for screening ESBL producers, such as the E-test. The rates of these ESBL-producing isolates in this study were lower than those in other studies reported from other parts of Turkey, but higher than those reported from the USA and Europe.