Browsing by Author "Özbakkaloglu, B"

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    Frequency of precore/core mutants in chronic Hepatitis B cases
    Akçali, S; Sanlidag, T; Biçmen, C; Özbakkaloglu, B; Alasehir, EA
    Objective: In recent years, the presence of precore/core region mutations were uncovered by the examination of Hepatitis B Virus (HBV) deoxyribonucleic acid (DNA) that is isolated from patient samples with anti-HBe seroconversion without viral replication loss. In this study, the frequency of precore/core mutations were investigated on serum samples obtained from chronic hepatitis B patients. Methods: From a total of 100 samples 69 anti-HBe and HBV DNA positive, and 31 HBeAg and HBV DNA positive samples were analyzed in the study to determine the mutations with the INNO-LIPA method at the Serology laboratory. Statistical analyses were bone with, SPSS v11.5 and chi-square and variance analysis (ANOVA) tests were conducted. Results: The precore mutations were detected in 68, while the core promoter mutations were present in 57 samples. Mutations were detected at the precore region in 11 out of 31 HBeAg positive (35%), and 57 out of 69 anti-HBe positive samples (83%). Likewise, the core promoter region was affected in 10 of 31 HBeAg (32%), and 47 out of 69 anti-HBe positive samples (68%). Both precore and core promoter mutations were substantially higher in the anti-HBe positive group (p<0.05). Conclusion: As a result, since precore/core mutations were prevalent in samples obtained from the study group, it is our opinion that careful attention must be paid to such mutations during the diagnosis and treatment phases of chronic hepatitis B patients.
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    DISTRIBUTION OF HEPATITIS C VIRUS GENOTYPES IN MANISA REGION, TURKEY
    Sanlidag, T; Akçali, S; Özbakkaloglu, B; Ertekin, D; Akduman, E
    The duration of hepatitis C virus (HCV) infection and the response to the standard therapy is strongly related to the HCV genotypes. In addition, the geographical distribution of HCV genotypes is important for the epidemiological studies in terms of distribution and possible risk groups. The aim of this retrospective study was to investigate the distribution of HCV genotypes in Manisa region (located at the Aegean part of Turkey). A total of 100 anti-HCV (microparticle EIA; Abbott Laboratories, USA) and HCV-RNA (real time RT-PCR; Applied Biosystems, USA) positive patients (53 female, 47 male; mean age: 44.4 +/- 10.4 years), who were admitted to Celal Bayar University Medical School Hospital between 2002-2005, were included to the study. Quantitative HCV-RNA levels of the patients were between 10(4)-10(8) copies/ml. Complementary DNAs obtained from HCV-RNAs isolated by Invitek RTP DNA/RNA Virus Mini Kit were used for genotyping with selected primers [primer 11 (5'-AGG TCT CTG AGA CCG TGC ACC ATG AGC AC-3') and primer 13 (5'-CTG TGA GGA ACT ACT GTC TT-3') for the first PCR; primer 12 (5'-ACT GCC TGA TAG GGT GCT TGC GAG TG-3') and primer 14 (5'-CAC GCA GAA AGC GTC TAG-3') for the second PCR]. The RT-PCR products were purified with Invisorb Spin PCRapid Kit and sequenced by BigDye Terminator v3.1 Cycle Sequencing Kit in ABI Prism 310 Genetic Analyzer. Genotype I was found in 92% of the patients (92%) and genotypes 2 and 4 were found in 7% of the patients, while HCV genotype could not be identified in one patient (1%). When evaluating the subtypes, genotype 1b was determined in 90 patients (90%), genotype 4a in five patients (5%), genotype 1 a in two patients (2%) and genotype 2a in two patients (2%). In conclusion, 1b was found to be the most common HCV genotype in Manisa region in concordance with the previous data obtained in Turkey, followed by genotype 4a, although a rare one. The data of this study is noteworthy especially for the arrangement of treatment and follow-up of HCV infected patients.
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    Second-line drug susceptibilities of multidirug-resistant Mycobacterium tuberculosis isolates in Aegean region - Turkey
    Özkütük, N; Sürücüoglu, S; Gazi, H; Coskun, M; Özkütük, A; Özbakkaloglu, B
    Aim: The emergence of multidrug-resistant tuberculosis (MDR-TB) is increasing, and the standard short-course regimen used for the treatment of TB is likely to be ineffective against MDR-TB, leading to the need for second-line drugs. In such situations, drug susceptibility testing is necessary to select an appropriate treatment regimen. Unfortunately, there are few studies showing the pattern of the second-line drug resistance in Turkey. We aimed to analyze the resistance to second-line anti-tuberculosis drugs of MDR strains of Mycobacterium tuberculosis isolated from the Aegean region of Turkey. Materials and Methods: In this study, drug susceptibility testing of 40 MDR-TB strains isolated from the Aegean region of Turkey was performed using the BACTEC 460 TB radiometric system. Capreomycin, ethionamide, kanamycin, amikacin, clofazimine and ofloxacin were tested in 1.25 mu g/ml, 1.25 mu g/ml, 5.0 mu g/ml, 1.0 mu g/ml, 0.5 mu g/ml, and 2.0 mu g/ml concentrations, respectively. Results: The results showed that 37.5% of the strains were resistant to ethionamide, 25% to capreomycin, 5% to kanamycin, amikacin and ofloxacin, and 2.5% to clofazimine. One (2.5%) of the 40 MDR-TB cases was defined as extensively drug-resistant tuberculosis (XDR-TB). Conclusions: The results of the study indicate that the high rates of resistance to ethionamide and capreomycin may be a problem in the treatment of patients with MDR-TB; XDR-TB is not yet a serious problem in our region.
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    β2-Microglobulin Levels in Hepatitis C Virus Infection
    Sanlidag, T; Akçali, S; Tosun, I; Özbakkaloglu, B
    The aim of this study is determine the relation between the beta(2)-microglobulin level and hepatitis C virus (HCV) infection. 77 haemodialysis (75.0% anti-HCV positive, 25% anti-HCV negative) and 34 control patients (58.8% anti-HCV positive, 41.2% anti-HCV negative) were evaluated in this study. The HCV antibodies were tested by using the enzyme immune assay (EIA) (UBI-HCV 4.0 Organon teknika) and the serum beta(2)-microglobulin levels were also tested by nephelometric assay (Dade Behring). beta(2)-microglobulin levels were measured higher than the normal value in three of 20 positive anti-HCV antibodies patients, and also higher in one of 14 negative anti-HCV antibodies patients. HCV antibodies was found positive in 58 of 77 haemodialysis patients. In this group, beta(2)-microglobulin levels were higher than the normal value in 39 patients. In nine of 19 haemodialysis patients, which have negative HCV antibodies, beta(2)-microglobulin levels were elevated. In patient group, beta(2)-microglobulin levels were elevated 12.4 fold in haemodialysis and 2.7 fold in HCV positivity. Multipl variants were also analyzed. Haemodialysis alone (independent from HCV seropositivity) was increased the level of beta(2)-microglobulin in 11.7 (3.7-36.8) (p<0.05) fold, however, HCV positivity alone (independent from haemodialysis) was increased the level in 2.3 fold (0.9-5.9) and this value was statistically insignificant (p>0.05). As a conclusion, the relation of haemodialysis and beta(2)-microglobulin levels were found statistically significant. In additionaly, the effect of HCV positivity in elevation of beta(2)-microglobulin levels should be investigated in wide series.
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    Evaluation of rational antibiotic use
    Tünger, Ö; Dinç, G; Özbakkaloglu, B; Atman, ÜC; Algün, Ü
    The emergence of antibiotic resistant bacteria is a major problem throughout the world and a rational use of antibiotics is therefore very important. This study was performed to estimate the appropriateness of antimicrobial drug use in Celal Bayar University Hospital in Manisa. The data of all inpatients (n = 937) between October and December 1998 were collected according to the Kunin and Jones criteria. Of the patients, 16.6% (n = 156) were receiving antibiotics, and in 63.5, 23.0 and 13.5% of these, a single, two and three agents were used, respectively. The purpose of antibiotic use was for prophylaxis in 23.9%, as an empiric decision in 71.4% and for therapeutic culture-based reasons in 4.7%. The rate of rational antibiotic use was 45.7% and it was statistically higher in those patients from whom specimens had been taken for culture than in patients receiving prophylactic or empiric antibiotics. On medical wards, rational antibiotic usage was 55.1%, while it was 26.3% in surgical wards (P < 0.0001). The low rate of appropriate antibiotic use in our university hospital reflects the urgent need of rationalization. (C) 2000 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.
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    The Comparison of Cell Culture, Hybridization and Direct Flourescent Antibody Tests in Chlamydia trachomatis Diagnosis
    Akduman, E; Ecemis, T; Sagol, S; Çiçek, C; Vatansever, S; Özbakkaloglu, B
    Objective: The aim of this study was to compare the reliability of hybridization and direct fluorescent antibody tests for the diagnosis of genital Chlamydia trachomatis infections. Material and Methods: Cervical specimens from 100 infertile women were evaluated with hybridizasyon, direct fluorescent antibody tests, and cell culture method known as a gold standard, and also sensitivity, specificity, positive and negative predictive values of the three methods were compared. Results: C. trachomatis was isolated in cell cultures of 11 samples. Seven and 19 positive samples were found respectively through direct fluorescent antibody, and hybridization tests identified 7, and 19 positive samples, respectively. Direct fluorescent antibody tests demonstrated 54.5 % sensitivity, 98 % specificity, 47.4 % positive, and 94.6 % negative predictive value, while the corresponding percentages for hybridization tests were 81.8, 88.8, 47.4, and 97.5 %, respectively. Conclusion: It was concluded that a single method has not sufficient sensitivity and specificity for the establishment of a definitive diagnosis C. trachomatis infection, and the results should be confirmed by other methods the hybridization method being more rapid and effective than the other methods.
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    Roles of Phospholipase, Esterase and Slime Activities of Candida albicans Strains in Infection-Colonisation Differentiation
    Pekintürk, N; Degerli, K; Özkütük, N; Ecemis, T; Kurutepe, S; Özbakkaloglu, B
    Objective: This study investigated slime factor, phospholipase and esterase activities of C. albicans strains isolated as the infectious agent from healthy individuals, their effectiveness as virulence factors and interactions between each other. For this purpose, virulence factors of 50 C. albicans strains isolated from specimens as infectious agent (infection group) and 50 C. albicans isolates obtained from oral smears of the control group (control group) were analyzed and roles of virulence factors in differentiation of colonisation and infection were investigated. Material and Methods: C. albicans ATCC 10039 and 50 C. albicans strains isolated from clinical specimes of patients who were treated in various clinics of our hospital were used as reference strains. The strains isolated from sterile body sites and from clinical specimens containing pseuduhyphe on direct examination were considered as infectious agent and were identified as C. albicans by germ tube test and chlamidospore formation. Yolc sac agar medium was used to detect phospholipase activity, Tween 80 agar medium was used to detect esterase activity and Kongo red brain-heart infusion agar medium was used to detect slime activity. Results: There was no significant difference in terms of slime, phospholipase and esterase activities of C. albicans strains isolated from patients compared to controls (p=0.357, p=0.842, p=0.841). Consistency analysis between virulence factors revealed no significant difference in the patient group. In the other hand, in the control group, esterase/phospholipase coexistence consistency was significant (K value=+0.35, p=0.001). Conclusion: In conclusion, we suggest that many virulence factors of C. albicans have important roles in the development of C. albicans-related infections.
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    In vitro susceptibility of Staphylococcus aureus and coagulase-negative Staphylococcus strains to fusidic acid
    Tünger, Ö; Arisoy, A; Kurutepe, S; Akçali, S; Özbakkaloglu, B
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    Relationship between pinworm and urinary tract infections in young girls
    Ok, ÜZ; Ertan, P; Limoncu, E; Ece, A; Özbakkaloglu, B
    Urinary tract infection is particularly common in young girls and Enterobius vermicularis (pinworm) is one of the most prevalent worms found in children worldwide, Young girls, with or without urinary tract infection, were examined for pinworms in order to explore a possible relationship between these two problems. Of the 55 young girls with urinary tract infection, 20 (36.4%) had pinworm eggs in the perianal and/or perineal region monitored using the cellophane tape method, while 9 (16.4%) of 55 young girls who had never previously had a urinary tract infection were found to have Enterobius eggs in at least one of the cellophane tape tests, and the difference was found to be significant (p<0.05). These results suggested that urinary tract infections may be related to pinworms. When a urinary tract infection is diagnosed in young girls, cellulose tape should be applied to both the perianal and the perineal regions on at least three consecutive occasions.
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    Antimicrobial susceptibility of bacterial pathogens in the oropharynx of healthy school children in Turkey
    Gazi, H; Kurutepe, S; Sürücüoglu, S; Teker, A; Özbakkaloglu, B
    Background & objectives: Information on oropharyngeal carriage rates of Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus Pyogenes and Moraxella catarrhalis and their resistance pattern in healthy school children in Turkey is lacking. The present study was undertaken to determine the carriage rates and antimicrobial resistance of these bacterial pathogens in such children aged 6-14 yr in Manisa, Turkey. Methods: A total of 1022 children were included from nine schools selected randomly from 32 schools. Throat swabs were cultured for bacteria which were identified using standard microbiological methods. Antimicrobial susceptibility was determined as per National Committee for Clinical Laboratory Standards guidelines. Results: Of the 1022 children 240 (23.4%) harboured S. pneumoniae, , 162 (15.8%) H. influenzae. 30 (2.9%) S. pyogenes and 82 (8%) M.. catarrhalis in their oropharynx. For S. peumoniae overall 17.9 per cent of the isolates were intermediately and 7 per cent were resistant to penicillin and resistance to erythromycin trimethoprim-sulphamethoxasole (TMP/SMX), and chloramphenicol was 13.7, 9.1 and 1.6 per cent, respectively. Ampicillin resistance observed in 20.9 per cent of H. influenzae isolates was associated with the presence of D-lactamase. except two isolates interpreted as -lactamase-negative ampicillin resistant strains. Resistance of H. influenzae to TMP/SMX, chloramphenicol, azithromycin, cefaclor and amoxicillin/clavulanic acid was 14.2. 2.4, 1.8, 1.2 and 1.2 per cent, respectively. M. catarrhalis isolates produced beta-lactamase in 80.5 per cent of the cases and all were susceptible to macrolides and clavulanic acid/amoxicillin combination; the highest rate of resistance of 17 per cent was for TMP/SMX. One (3.3%) isolate of S. pyogenes was resistant to macrolides tested. Interpretation & conclusion: Our data shows that upper respiratory tract of about 50 per cent children was colonized with respiratory pathogens. There is a need for surveillance of nasopharyngeal carriage of resistant strains in healthy school children.
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