Browsing by Author "Ecemis, T"

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    Seroprevalence of West Nile virus, Crimean-Congo hemorrhagic fever virus, Francisella tularensis and Borrelia burgdorferi in rural population of Manisa, western Turkey
    Gazi, H; Özkütük, N; Ecemis, T; Atasoylu, G; Köroglu, G; Kurutepe, S; Horasan, GD
    Background & objectives: Zoonotic diseases are well recognised threat to public health globally. The information of regional prevalence and associated risk factors allow the national programmes to determine and frame better strategies for their control, as they also provide the actual status of zoonosis in the region. The aim of this study was to determine the seroprevalence of West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus (CCHFV), Francisella tularensis and Borrelia burgdorferi among the rural residents of Manisa region, Turkey and to identify the associated risk factors. Methods: Cross sectional study was conducted in rural parts of Manisa, Aegean region of western Turkey in 2012. Blood samples from 324 randomly selected subjects were screened for the presence of IgG antibodies to WNV, CCHFV, F. tularensis and B. burgdorferi with commercially available kits. The demographic structure of the rural residents and risk factors related to lifestyle such as outdoor agriculture activities, animal husbandry, hunting and history of tick bite were questioned and their relationships with positive results were analyzed statistically. Results: It was observed that 49 subjects (15%) had IgG antibodies to at least one of the zoonotic agents studied. The seroprevalence of F. tularensis was highest with a percentage of 7.1% (n = 23). Distribution of the positive results for WNV, CCHFV and B. burgdorferi were 4.3% (n = 14), 3.7% (n = 12) and 0.9% (n = 3), respectively. Older age and uncompleted secondary education were the statistically significant risk factors for seropositivity to at least one zoonotic agent investigated. Logistic regression analyses confirmed that older age (over 50) increased the risk of WNV and CCHFV seropositivity. Interpretation & conclusion: Seropositivity rates were not found to be higher than the expected rates. Further, studies are needed to evaluate the threat of vector borne zoonoses and associated risk factors in the study area.
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    Evaluation of antimicrobial susceptibilities of rapidly growing mycobacteria by Sensititre RAPMYCO panel
    Cavusoglu, C; Gurpinar, T; Ecemis, T
    This study used Sensititre RAPMYCO to test the activities of amikacin, cefoxitin, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, sulfamehoxazole, tigecycline and tobramycin against 25 clinical isolates of rapidly growing mycobacteria (RGM), including the common disease producing species Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium fortuitum and Mycobacterium peregrinum. Analysis of the four different RGM species showed that isolates of M. fortuitum and M. peregrinum were more susceptible than M. abscessus and M. chelonae. Different antimicrobials showed a variable sensitivity in all strains. Therefore, each species and strain must be individually evaluated, and it is always advisable to perform in vitro sensitivity tests before the treatment of infections due to RGM.
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    Evaluation of Serological Tests for Diagnosis of Brucellosis
    Pabuccuoglu, O; Ecemis, T; El, S; Coskun, A; Akcali, S; Sanlidag, T
    The aim of the present study was to compare serological tests (Rose Bengal [RB]; standard agglutination test [SAT]; enzyme immunoassay [ETA] for detection of IgM, IgA, and IgG; and 2-mercaptoethanol [2-ME] test) that are routinely used in patients prediagnosed with different clinical types of brucellosis (acute, subacute, or chronic), and to evaluate the results of the IgG avidity test. Ninety-two patients having titers >= 1/160 as measured by SAT were included in the study. The IgG avidity test was performed in 78 patients who had positive EIA-IgG results. RB test results were positive in 88 (95.7%) patients. A statistically significant correlation was found between a positive EIA-IgM result and the diagnosis of acute brucellosis. When compared to the results of the SAT, the 2-ME test showed a lower titer in 55 (59.8%) patients, and the agreement between the 2-ME test and EIA-IgG was calculated as 84.8%. No statistical difference was found between the 40% avidity index used in the IgG avidity test and avidity maturation time (6 months). From our study, we concluded that (i) the RB and SAT tests are appropriate and reliable tests for the serological diagnosis of brucellosis; (ii) IgM can be used as a marker of acute brucellosis; (iii) the 2-ME test, similar to EIA, can be used to determine IgM levels; and (iv) the IgG avidity test should be standardized.
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    Investigation of the Correlation Between Anti-HCV Levels (S/Co) with HCV-RNA in the Diagnosis of Hepatitis C Virus (HCV) Infection
    Sanlidag, T; Akçali, S; Ecemis, T; Süer, K; Erbay Dündar, P; Arikan, A; Güvenir, M; Güler, E
    Detection of borderline and/or low positive anti-HCV results by enzyme immunoassay (EIA) leads to severe problems in routine laboratories and needs confirmation with nucleic acid amplification tests which can increase the cost. In EIA tests, if the ratio of sample to cut-off (S/Co) is >= 1, the sample is accepted as positive according to the manufacturers' instructions. Although over the last decade the application of S/Co values have also applied to HCV-RNA readings, the current study aims to determine whether the S/Co value is adequate and applicable for the anti-HCV EIA test, and to determine whether a correlation exists between HCV-RNA and HCV infections. A total of 658 cases (402 female, 256 male; mean age: 49.4 +/- 17.0 years) who were found anti-HCV positive between January 2011-July 2013 were included in the study. Anti-HCV tests were performed by chemiluminescent EIA (Architect i2000SR, Abbott, USA and LiaisonXL Murex, DiaSorin, Italy) and HCV-RNA by real-time PCR (Cobas Ampliprep/Cobas TaqMan HCV, Roche, USA). The mean S/Co value of the cases was 7.3 +/- 4.8 (range: 1.00-17.59) and mean HCV-RNA value was 2.3x10(5) +/- 2.1x10(6) copies/ml. When the anti-HCV S/Co value of varying ranges was compared with HCV-RNA readings a particular trend was noted. In the anti-HCV S/Co values of 1.0-4.0; 4.1-7.0; 7.1-10.0; 10.1-13.0; 13.1-16.0 and (3)16.1, HCV-RNA positivity rates were detected as 1.9%, 24.7%, 37.1%, 46.7%, 56.4% and 75%, respectively. Statistical analysis indicated an intermediate positive correlation (r=0.454) between anti-HCV ve HCV-RNA readings (p=0.000). An adequate S/Co value was accepted as 5.0 based on the ROC analysis, and this value gave a performance confidence level of 95.6% when determining whether a patient is HCV positive. Based on the data of this study it became evident that further EIA testing is not required if the S/Co value is >= 5.0, however if the S/Co value is less than 5.0, then further clinical analysis and revaluation of the patient is required.
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    Antibody Sustainability in SARS-CoV-2 Healthcare Professionals' Patient Cohort
    Eser, E; Akar, SS; Akçali, S; Ecemis, T; Dündar, PE; Çiçek, K; Akman, D; Tüzün, E; Erkekoglu, GS; Buran, ZC; Arikan, ZÖÖ; Yalçin, FK
    In this study, it was aimed to evaluate one-year follow-up of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) specific antibodies formed against the virus binding site, in a coronavirus disease-2019 (COVID-19) positive case cohort (n= 413) between the period March 2020 to December 2020 in Manisa Celal Bayar University Hospital, until July 2021. SARS-CoV-2 antibodies were determined by the chemiluminescent enzyme immunoassay (CLIA) method. Values of 1.0 and above were considered positive. Chi-square tests and Joinpoint regression analysis (version 4.7.0) were used in the statistical analyses. The mean age of the participants was 34.9 +/- 9.3 and 60.2% of them were women. Between 21-30 days after the diagnosis of COVID-19, total antibody level was above the threshold value in 72.2% (n= 126) of the participants, while this rate increased to 79.1% (n= 240) in 31-60 day interval. In the following period, this rate decreased to 38.8% (n= 108) in days 211st to 240th. Antibody response could not be detected in 76 (20.7%) of 367 employees who have initially been followed up. The percentage of total antibody positivity prevalence ranged from 98.9% to 96.1% in the 31-210th day after diagnosis, in the follow-up of 291 employees whose total antibody positivity was detected after diagnosis. According to the results of the Joinpoint regression analysis, after the diagnosis of COVID-19, the curve showing the percentage of antibody positivity was broken at two points: The first breaking point was observed in 181-210th days (6-7 months) (p= 0.069), and the second breaking point was in 271-300th days (9-10 months) (p< 0.001). As a result, the highest antibody positivity rates were detected after the 30th day of the disease onset and antibody positivity was maintained in the first seven months after diagnosis; the antibody positivity rate decreased to 25% at the end of the first year.
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    Human Papilloma Virus Frequency and Genotype Distribution in a Turkish Population
    Akcali, S; Goker, A; Ecemis, T; Kandiloglu, AR; Sanlidag, T
    Objectives: To determine human papillomavirus (HPV) frequency, genotypes and the relation between cervical smear results, risk factors and types in women living in Manisa, Turkey. Materials and Methods: A total of 410 women were included in the study. Cervical specimens were obtained for linear array HPV genotyping and pathological testing. Conventional Pap test and Bethesda system were used for evaluation of cytology specimens. Results: A total of 410 women with a mean age of 34.9 years were tested. A positive result of any HPV was found in 35 patients (8.5%). Among them, 26 different serotypes of HPV were identified and the most frequent type was HPV 16 (28.5%) followed by type 45 and 53 (11.4%). Patients were infected by 65.7% high risk, 11.4% probable high risk and 22.9% low risk HPV types. Multiple HPV positive results were found in 13 patients (37.1%). Patients with single partner, history of abnormal smear or condyloma had positive HPV results and this was statistically significant (p<0.05). Correlation analysis showed a statistically weak relation between positive HPV and abnormal smear results (r=0.120). Conclusions: Determining HPV types of genital HPV infections is important for epidemiological studies. We have found the rate of positive HPV as 8.5% which implies the need for extended screening programs in order to diagnose oncogenic HPV at an early stage.
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    Agents of Otomycosis in Manisa Region, Turkey, 1995-2011
    Degerli, K; Ecemis, T; Günhan, K; Baskesen, T; Kal, E
    Otomycosis, which is otitis externa caused by fungi, is common throughout the world especially in tropical and subtropical countries. However, the epidemiologic data about the etiologic agents of otomycosis in Turkey is limited. The aim of this retrospective study was to evaluate the agents of otomycosis in patients living at Manisa region (located at western Anatolia of Turkey). A total of 2279 cases [1465 male, 813 female; age range 1-87 (mean: 41.7) years] who were clinically prediagnosed as otomycosis at Celal Bayar University Hospital, between February 1995 and July 2011, were included in the study. External ear swab samples from patients with suspicion of otomycosis have been evaluated by routine mycological methods. Identification of mold-like fungi was based on colony morphology and microscopic examination of fungal structure, whereas germ tube test, growth characteristics on cornmeal-Tween 80 agar and API 20C AUX (bio-Merieux, France) system were used for the identification of yeast-like fungi. Of the samples, 28% (638/2279) were found positive by direct microscopy and 24% (544/2279) by culture methods. Among culture-positive cases the isolation rates of mold-like and yeast-like fungi were 66% (359/544) and 34% (185/544), respectively. The number of distribution of the molds were as follows; Aspergillus niger (180), Aspergillus fumigatus (95), Aspergillus terreus (32), Aspergillus flavus (23), Aspergillus spp. (14), Penicillium spp. (13), Trichophyton spp. (T.rubrum 1, T.mentagrophytes 1); while this distribution was as follows for the yeasts; Candida tropicalis (97), Candida albicans (39), Candida parapsilosis (21), Candida glabrata (19), Candida kefyr (4), C.guilliermondii (2), Candida krusei (1), Geotrichum candidum (1) and Trichosporon capitatum (1). It was notable that 96% (344/359) of mold-like fungi were Aspergillus spp., and 99% (183/185) of yeast-like fungi were Candida spp. The results of this study indicated that the most frequent agents of otomycosis were non-dermatophyte species such as Aspergillus, followed by Candida. Dermatophytes were isolated in a small number of otomycosis cases. These data will provide support to the establishment of antifungal therapy guidelines for otomycosis.
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    Seroprevalance of Measles, Rubella, Mumps, Varicella, Diphtheria, Tetanus and Hepatitis B in Healthcare Workers
    Ciliz, N; Gazi, H; Ecemis, T; Senol, S; Akcali, S; Kurutepe, S
    Objective: We aimed to determine the antibody levels of healthcare workers of Celal Bayar University Hospital against vaccinepreventable diseases such as measles, rubella, mumps, diphtheria, tetanus, varicella and hepatitis B, and encourage compliance to recommended vaccinations for non-immune staff. Methods: The antibody levels were tested by enzyme-linked immunosorbent assay (ELISA). Demographic characteristics were collected by a questionnaire, and the history of the diseases, immunization and the sharps-related injuries were queried. Results: 44% percent of 309 healthcare personnel were exposed to occupational injury at least once, and 78.3% of the injuries were needle-stick injuries. Injuries were found to be more common among doctors and nurses, and pediatric and surgical departments, respectively. Frequency of anti-HBs positivity among healthcare workers was 84.1%, while 71.5% of healthcare workers were immunized with HBV vaccine before starting to work, and the immunization status directly correlated with the level of education. In general, high seropositivity was noted for measles (99.7%), rubella (97.0%), mumps (99.7%) and varicella (99.7%), while diphtheria (60.8%) and tetanus (93.5%) antibody levels significantly decreased with age. Histories of the disease and vaccination were not reliable while verifying the immunity status. Conclusions: It is necessary to increase adherence to universal protective measures in healthcare workers and to take corrective and protective measures for sharps-related injuries. It is also essential to increase hepatitis B vaccination rates and to confirm the immune status of medical staff working in high risk departments and diphtheria and tetanus vaccinations should be repeated once every ten years.
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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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    The necessity of culture for the diagnosis of tinea pedis
    Ecemis, T; Degerli, K; Aktas, E; Teker, A; Ozbakkaloglu, B
    Background. This study examined the consistency between the clinical diagnosis of tinea pedis and the results of direct fungal examination, prepared with 10% potassium hydroxide, and culture. Methods: 2427 patients clinically diagnosed with tinea pedis who presented to the mycology laboratory were reviewed retrospectively for the outcomes of direct fungal examination and culture. Results: Direct examination was positive in 54.3% and culture was positive in 36.6% of the cases. The sensitivity and specificity of direct microscopy were 95.7% and 69.6%, respectively Conclusions: The clinical diagnosis of tinea pedis can be misleading, since it features lesions that can also be present in some other skin diseases and direct microscopy may be insufficient to confirm the diagnosis. Therefore, we suggest using culture for a definitive diagnosis.
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    Relationship Between Duodenal Histopathology and Strong Positive Tissue Transglutaminase Antibodies in Children with Celiac Disease
    Dogan, G; Ayhan, S; Yilmaz, B; Appak, YÇ; Dündar, PE; Ecemis, T; Ünal, F; Kasirga, E
    Introduction: In celiac disease (CD) strong positive tissue transglutaminase antibody (TTGA) levels (> 100 U/A) have been shown to almost always indicate villous atrophy. The aim of this study is to determine the sufficiency of >= 100 U/A Ig A type TTGA levels for diagnosis of CD. Materials and Methods: Results from duodenum biopsy performed due to positive TTGA in 197 children were retrospectively examined. IgA TTGA levels had a positive value of > 18 U/A. Increases of 5 times or more than this threshold value (>= 100 U/A) are accepted as strong positivity. CD diagnosis was made according to ESPGHAN criteria. A modified Marsh stage >= 2 was accepted as significant for CD. Results: Of the cases, 129 were female (65.5%) and 68 were male (34.5%). Duodenum histopathology was compatible with Marsh 0 for 1 case (0.5%), Marsh 2 for 17 cases (8.6%), Marsh 3a for 41 (20.8%), Marsh 3b for 81 (41.4%) and Marsh 3c for 57 (28.9%). The TTGA levels of 64 of the 197 cases (32.5%) were >= 100 U/A. In cases with strong positivity for TTGA the duodenum histology was compatible with Marsh 3 (villous atrophy) for 63 and Marsh 0 (normal histology) for 1 case (type 1 diabetic and asymptomatic for CD). For Marsh 3c TTGA levels >= 100 U/A had a sensitivity of 85.96% (95% CI: 74.2-93.7%), specificity of 89.29% (95% CI: 82.9-93.8%), positive predictive value of 76.56% (95% CI: 64.3-86.2%) and negative predictive value of 93.9% (95% CI: 88.4-97.3%). Conclusions: This study showed that positive IgA TTGA levels (>= 100 U/A) were almost always accompanied by Marsh 3 duodenal histopathological changes. Diagnosis of CD without biopsy may miss certain accompanying diseases, however in some cases with advanced examinations CD may be diagnosed by pediatric gastroenterology specialists without endoscopy.
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    Relationship of herpesvirus (HSV1, EBV, CMV, HHV6) seropositivity with depressive disorder and its clinical aspects: The first study in children
    Bayturan, S; Sapmaz, SY; Uzun, AD; Kandemir, H; Ecemis, T
    Infections can lead to the onset of mood disorders in adults, partly through inflammatory mechanisms. However pediatric data are lacking. The aim of this study is to evaluate the relationship between depressive disorder and seropositivity of herpes virus infections in children. The sample group consisted of patients diagnosed with depressive disorder according to DSM-5 diagnostic criteria and healthy volunteers, being between 11 and 18 years with clinically normal mental capacity. All children completed DSM-5-Level-2 Depression Scale, DSM-5-Level-2 Irritability Scale, DSM-5-Level-2 Sleep Scale, DSM-5-Level-2 Somatic Symptoms Scale. The levels of anti-HSV1-IgG, anti-CMV-IgG, anti-EBNA, and anti-HHV6-IgG were examined in all participants. Patients with an antibody value above the cut-off values specified in the test kits were evaluated as seropositive. The mean age was 15.54 +/- 1.57 years in the depression group (DG), 14.87 +/- 1.76 years in the healthy control group (CG). There were 4 boys (11.2%), 32 girls (88.8%) in the DG, 9 boys (21.9%) and 32 girls (78.04%) in the CG. There was no statistically significant difference between the groups in terms of the presence of seropositivity of HSV1, CMV, EBV, and HHV6. HHV6 antibody levels were significantly higher in the DG (p = 0.000). A significant positive correlation was found between HHV6 antibodies and DSM-5 level-2 somatic symptoms scale score. HHV6 antibody levels were found to be significantly higher in patients with existing suicidal ideation in the DG (n = 13) compared to those without existing suicidal ideation in the DG (p = 0.043). HHV6 persistent infections may be responsible for somatic symptoms and etiology of suicidal ideation in childhood depressive disorder.
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    Antimicrobial Resistance of Gram-Negative Bacteria Isolated from Lower Respiratory Tract Specimens of Hospitalized Patients
    Gazi, H; Ecemis, T; Kurutepe, S; Gürsev, N; Sürücüoglu, S
    Objective: In this study, we aimed to determine the distribution of the genera of Gram-negative bacteria isolated from lower respiratory tracts of patients treated as in-patients and to calculate the antibiotic resistance rates to guide empirical antibiotic therapy. Methods: Samples taken from the lower respiratory tract and sent to the Bacteriology Laboratory at the Celal Bayar University Faculty of Medicine from January 2008 to December 2010 were retrospectively analyzed. Results: A total of 853 Gram-negative bacteria were isolated from specimens of in-patients. The rates of carbapenem (85%) and multidrug resistance (47%) among A. baumannii were higher than those observed for P. aeruginosa (30% and 19.2%). Carbapenem resistance was not found among the bacteria of the family Enterobacteriaceae, while the highest rates of resistance were detected for ciprofloxacin and trimethoprim-sulfamethoxazole. Conclusions: Implementation of effective treatment protocols based on sensitivity test results can be useful in preventing nosocomial lower respiratory infections caused by resistant Gram-negative bacteria.
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    The Threshold Value of Anti-HCV Test in the Diagnosis of HCV Infection
    Ecemis, T; Akçali, S; Dündar, PE; Sanlidag, T
    Objective: The initial step in the diagnosis of hepatitis C virus (HCV) infection is to screen for anti-HCV antibody, followed by confirmation of positive results with nucleic acid amplification tests. In the recent studies, using reactivity threshold, S/Co (signal to cut-off) ratio greater than 1 has yielded results that are highly consistent with HCV-RNA test. We aimed to determine the most appropriate S/Co level for anti-HCV enzyme immunoassay (ETA) that would predict HCV infection. Material and Methods: We compared the results of 387 patients acquired by Anti-HCV using microparticle ETA and HCV-RNA using hybridization methods. Taking the HCV-RNA test as gold standard for HCV infection, the sensitivity, specificity and predictive values of ETA test were determined and receiver operating characteristic (ROC) analysis was performed to detect the best threshold of reactivity. Results: ETA test showed 197 (49.2%) positive and 190 (50.9%) negative results, and the sensitivity and specificity were calculated as 94.9% and 60.4%, respectively. Positive and negative predictive values were 38.1% and 97.9%, respectively. ROC analysis revealed that the best S/Co level was 5 and, based on this value, sensitivity and specificity were 92.4% and 76.6%, respectively. Computed positive predictive value was 50.3% and negative predictive values was 97.5%. Conclusion: We investigated the best values of reactivity for anti-HCV ETA test and found S/Co >= 5.
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    PYRAZINAMIDE MONORESISTANT MYCOBACTERIUM TUBERCULOSIS IN MANISA REGION, TURKEY
    Özkütük, N; Ecemis, T; Sürücüoglu, S
    Pyrazinamide (PZA) is a primary antituberculous drug. BACTEC 460TB is the recommended reference method for the detection of PZA resistance in Mycobacterium tuberculosis. This method is more expensive than the conventional susceptibility methods and therefore, it is recommended that each laboratory should establish their own protocol for the inclusion of PZA in the panel of primary drugs tested. One of the most important factors that help this decision is the prevalence of PZA resistance, particularly PZA monoresistance in the related community. The aim of the present study was to determine the extent of PZA monoresistance in M.tuberculosis complex (MTBC) isolates in our region. In this study, PZA susceptibility testing of 109 MTBC strains (susceptible to isoniazid, rifampicin, ethambutol and streptomycin) isolated from Manisa province in the Aegean region of Turkey was performed by using the BACTEC 460TB radiometric system (Becton Dickinson, MD). Two (1.8%) of the 109 isolates which were susceptible to all primary drugs revealed monoresistance against PZA. One of the PZA-monoresistant isolates has been identified as M.bovis and the other as M.tuberculosis by molecular method (Genotype MTBC, Hain Lifescience, Germany). The results of our study indicated that since the rate of PZA monoresistance was low, susceptibility testing of a panel of primary drugs without PZA may be an economical alternative in our region.
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    Comparison of Lowenstein Jensen Medium and Bactec 460TB Culture System for Diagnosis of Tuberculosis
    Baskesen, T; Sürücüoglu, S; Özkütük, N; Ecemis, T
    Objective: In this study, it was intestigated that whether the use of Lowenstein Jensen (LJ) medium with BACTEC460 TB liquid culture system contributed to bacteria isolation rates for diagnosis of tuberculosis. Material and Methods: A total of 4237 specimens were evaluated in the study for the results of microscopic examination and culture. Of 4237 specimens, 2719 were obtained from respiratory tract and remaining 1518 were obtained out of the respiratory tract. Results: According to the results of culture. Mycobacterium tuberculosis complex were isolated in 271 (6.4%) specimens on BACTEC 460TB system and in 238 (5.6%) specimens on Lowenstein Jensen medium. Contamination rates at BACTEC 460TB system and Lowenstein Jensen medium were 3.6% and 10.2%, respectively. The mean times of recovery were determined as 9.6 days for BACTEC system and 21 days for Lowenstein Jensen medium. When contaminated specimens were excluded, Mycobacterium tuberculosis was grown on at least one culture technique in 258 out of 3718 (6.9%) specimens. Sensitivity of BACTEC 460 TB culture system was found as 96%, while sensitivity of Lowenstein Jensen medium was found as 92%. The correlation between two culture techniques was found as 99%. Contribution of BACTEC 460 TB system and LJ medium alone to culture positivity were found as 8.3% and 3.9% respectively. No statistically significant difference was found when microscopic evaluation and culture systems were compared. Conclusion: It was concluded that the liquid culture systems are needed for rapid detection of tuberculosis, however liquid and solid culture systems should be used together in order to reach maximum isolation rates.
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    Seroprevalance of Chlamydophila pneumoniae in Patients With Alzheimer's Disease and Vascular Dementia
    Ecemis, T; Mavioglu, H; Özkütük, N; Akçali, S; Karaçam, M; Sanlidag, T
    In recent years, it was been argued that Chlamydophila pneumoniae, which is an intracellular pathogen capable of causing chronic infection, might be effective in some forms of dementia, an argument confirmed or rejected by some studies. The objective of this study was to determine if there was an association between C. pneumoniae infection and Alzheimer's disease and vascular dementia. We tested 54 patients with Alzheimer and 29 patients with vascular dementia and 50 controls for C. pneumoniae IgG and IgA antibodies and analyzed the results statistically. C. pneumoniae IgG antibodies were found in 25 patients (49.2%) with Alzheimer's disease, 15 patients (51.8%) with vascular dementia and 22 controls (44%) whereas 6 patients (11.1%), 2 patients (6.9%) and 3 controls (6%), respectively, tested positive for IgA. It was found no serological evidence for a significant association between C. pneumoniae and Alzheimer's disease as well as vascular dementia.
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    Investigation of viral agents by multiplex PCR in children with symptoms of upper respiratory tract infection
    Ecemis, T; Yilmaz, Ö; Sanlidag, T; Akçali, S; Yüksel, H
    Objective: We evaluate the results of respiratory viral panel tested in children with symptoms of acute upper respiratory tract infections. Methods: Multiplex PCR test results of nasopharyngeal swap samples of 160 symptomatic children were analyzed. Results: Fifty-five patients (34.4%) had PCR test positivity. Two (n= 5 patients; 3.1%), and three (n= 1; 0.6%) viral species were detected. Rhinovirus was the most frequently detected species (n= 14; 25.4%). Conclusion: It was concluded that multiplex PCR is a reliable test which can simultaneously detect numerous viruses in a short time in accordance with the results of this study.