MCBÜ Açıkerişim Sistemi :: Browsing by Author "Sürücüoǧlu S."

Browsing by Author "Sürücüoǧlu S."

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Granulomatous hepatitis following intravesical bacillus Calmette-Guerin therapy
(1999) Özbakkaloǧlu B.; Tünger Ö.; Sürücüoǧlu S.; Lekili M.; Kandiloglu A.R.
Although intravesical bacillus Calmette-Guerin (BCG) administration is an effective method in the treatment of superficial urinary bladder carcinoma, some complications may arise such as a granulomatous reaction either in the urinary tract or, in rare cases, outside the urinary tract. We report in this paper a case of granulomatous hepatitis following intravesical BCG administration.
Extended spectrum beta-lactamase production and susceptibility to antibiotics in Escherichia coli strains isolated from community acquired and nosocomial infections; [Toplum kökenli̇ ve nozokomi̇yal i̇drar yolu enfeksi̇yonlarindan i̇zole edi̇len Escherichia coli suşlarinda geni̇şlemi̇ş spektrumlu beta-laktamaz varliǧinin araştirilmasi ve çeşi̇tli̇ anti̇bi̇yoti̇klere duyarliliklari]
(2001) Tünger Ö.; Sürücüoǧlu S.; Özbakkaloǧlu B.; Gazí H.
This study was planned to determine the extended spectrum beta-Lactamase (ESBL) production and antibiotic susceptibility of Escherichia coli strains isolated from patients with nosocomial and community acquired urinary tract infections. A total of 218 E. coli strains isolated from 126 community acquired and 92 nosocomial urinary tract infections were included to the study and ESBL production was investigated by double disk synergy method. ESBL positivity rates of isolates from patients with community acquired and nosocomial urinary tract infections were found to be as 3.9% and 9.8%, respectively (p<0.05). Susceptibility to amikacin, amoxicillin/clavulanate, aztreonam, gentamicin, imipenem, netilmicin, ofloxacin, piperacillin, cephalotin, cefepime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, trimethoprim/sulfamethoxazole was investigated by disk diffusion method, and although the resistance rates to these antimicrobials were found higher in nosocomial strains than those community strains, the differences were statistically insignificant, except for gentamicin.
Assessment of performance of "amplified Mycobacterium tuberculosis direct test" in pulmonary and extrapulmonary specimens; [Akci̇ǧer ve akci̇ǧer dişi örneklerde "ampli̇fi̇ye Mycobacterium tuberculosis di̇rek test" i̇n güveni̇li̇rli̇ǧi̇ni̇n deǧerlendi̇ri̇lmesi̇]
(2007) Sürücüoǧlu S.; Özkütük N.; Gazi H.; Çelik P.
Since rapid diagnosis is critical in control of tuberculosis, nucleic acid amplification techniques have been widely used. The purpose of the present study was to assess the performance of Amplified Mycobacterium tuberculosis Direct Test (Amplified MTD Test, Gen-Probe) for the diagnosis of pulmonary and extrapulmonary tuberculosis in our laboratory. A total of 267 specimens (170 pulmonary and 97 extrapulmonary) were tested in the Clinical Mycobacteriology Laboratory of Manisa (a province located in Aegean part of Turkey) University Hospital from September 2001 to March 2005. When Amplified MTD (AMTD) test results were compared to the culture results taken as the gold standard, the sensitivity, specificity, positive and negative predictive values (PPV, NPV) for pulmonary specimens were found to be 84%, 96%, 73%, and 98%, respectively. When AMTD test positive, culture negative discrepant results were evaluated against the clinical history of the patients, these rates were detected as; 88%, 100%, 100%, and 98%, respectively. For 97 extrapulmonary specimens, sensitivity, specificity, PPV and NPV of AMTD test were 60%, 100%, 100%, and 98%, respectively. In conclusion, the results of the AMTD assay were reliable for the rapid diagnosis of pulmonary tuberculosis; if the results were evaluated together with the clinical status of patients, the performance of the test would be increased. However, even though the culture positive extrapulmonary specimens were sparse in our study (5%), the sensitivity of the AMTD test in extrapulmonary specimens was found less than that in pulmonary specimens. Therefore it is thought that AMTD test results should be evaluated carefully for the diagnosis of extrapulmonary tuberculosis.
Comparison of interferon-gamma whole blood assay with tuberculin skin test for the diagnosis of tuberculosis infection in tuberculosis contacts; [Temaslιlarda tüberküloz enfeksiyonunun tanιsι için interferon-gama tam kan testi ile tüberkülin deri testinin karşιlaştιrιlmasι]
(2007) Öztürk N.; Sürücüoǧlu S.; Özkütük N.; Gazi H.; Akçali S.; Köroǧlu G.; Çiçek C.
Tuberculin skin test which is used for the detection of latent tuberculosis (TB), has many disadvantages such as false positivities due to cross reactions between environmental mycobacteria and BCG strain, false negativities due to immunosuppression and malpractice, and also difficulties in application and evaluation. Recently a new diagnostic test which measures the production of interferon (IFN)-gamma in whole blood upon stimulation with specific ESAT-6 and CFP-10 antigens of Mycobacterium tuberculosis has been introduced. Since most of the mycobacteria other than tuberculosis and BCG strain do not contain these antigens, the detection of IFN-gamma levels indicates the specific T-cell response against M.tuberculosis. The aim of the study was to compare the tuberculin skin test and whole blood IFN-gamma assay (QuantiFERON®-TB Gold, Cellestis Ltd, Carnegie, Victoria, Australia) for the identification of latent TB infection in the contacts with active TB patients. The tests results were evaluated by using Kappa (K) analysis, and K coefficients of <0.4, 0.4-0.75 and >0.75 were accepted as poor, moderate and excellent agreements, respectively. A total of 233 subjects from three risk groups were included to the study. Group 1 included the household members (n=133) who had contact with smear positive index cases, Group 2 included the subjects from community (n=46) who had contact with smear positive index cases, and Group 3 included health care workers (n=74) who had contact with TB patients or their specimens. The positivity rates of tuberculin skin test and IFN-gamma assay in the cases were found as 37% and 42%, respectively. There were no significant differences among the three patient groups with regard to the results of the tuberculin skin test (p>0.05). However, the positive result of the IFN-gamma assay in Group 1 was found statistically higher than the other groups (51.3%, p=0.013). A poor agreement between the two tests was detected in the results taken from 233 subjects (65.7%, K=0.28), while agreement was moderate in unvaccinated group (72.7%, K=0.44). Evaluation of agreement rates of the tests according to the risk groups yielded 64.6% (K=0.3) for Group 1, 71.7% (K=0.32) for Group 2, and 63.5% (K=0.21) for Group 3, which all coefficients showed poor agreement. Although IFN-gamma blood assay has many advantages such as objective and quantitative results, no interference with vaccination due to the use of specific antigens and being practical, the high cost and the need for well-equipped laboratory are its disadvantages. As a result it was concluded that, IFN-gamma blood assay has limited value for the detection of latent TB infection in our country, since the prevalence of TB infection and BCG vaccination rates are high in Turkey.
Pyrazinamide monoresistant Mycobacterium tuberculosis in Manisa region, Turkey; [Manisa bölgesinde pirazinamid-monorezistan Mycobacterium tuberculosis]
(2008) Özkütük N.; Ecemiš T.; Sürücüoǧlu 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.
Second-line drug susceptibilities of multidrug-resistant Mycobacterium tuberculosis isolates in Aegean Region - Turkey
(2008) Özkütük N.; Sürücüoǧlu S.; Gazi H.; Coşkun M.; Özkütük A.; Özbakkaloǧlu B.
Aim: The emergence of multidrug-resistant tuberculosis (MDR-TB) is increasing, and the standard shortcourse 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 μg/ml, 1.25 μg/ml, 5.0 μg/ml, 1.0 μg/ml, 0.5 μg/ml, and 2.0 μg/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. © TÜBİTAK.
Comparison of Löwenstein Jensen medium and BACTEC 460TB culture system for diagnosis of tuberculosis; [Tüberküloz tanısında Löwenstein Jensen besiyeri ile BACTEC 460TB kültür sisteminin karşılaştırılması]
(Turkiye Klinikleri, 2010) Baskesen T.; Sürücüoǧlu S.; Özkütüka N.; Ecemiş T.
Objective: In this study, it was intestigated that whether the use of Löwenstein 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 Löwenstein Jensen medium. Contamination rates at BACTEC 460TB system and Löwenstein 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 Löwenstein 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 Löwenstein 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. © 2010 by Türkiye Klinikleri.
Underestimated role of alcohol at skin disinfection: Lipid dissolving property when used in association with conventional antiseptic agents; [Alkolün cilt dezenfeksiyonunda önemsenmeyen rolü: Klasik antiseptik ajanlarla birlikte kullanıldıǧında lipit çözücü özelliǧi]
(Turkiye Klinikleri Journal of Medical Sciences, 2010) Yentür A.; Topçu I.; Işik R.; Deǧerli K.; Sürücüoǧlu S.
Aim: After conventional aqueous disinfectant solutions, it was shown that microorganisms were still protected in hair follicles. We hypothesized that those aqueous disinfectant solutions when used in combination with alcohol may be more effective on the inhibition of recolonization of skin and therefore catheter tip colonization. & Materials and methods: Skin surface samples were taken from epidural catheter insertion sites prior to catheterization, and before and after disinfection with different combinations of povidone-iodine, chlorhexidine, and alcohol. Before catheter removal, cultures were taken once more and tips of the catheters were cultured. & Results: Catheter tip colonization and skin culture results of 10% povidone-iodine + 70% alcohol group were significantly lower than those of other groups after disinfection. & Conclusion: Sequential use of alcohol and povidone-iodine is the most effective combination for limiting re-colonization of skin flora. Contamination of catheters appears to take place at removal or via the spread of these re-colonized bacteria along the catheter tract. © TÜBİTAK.
Antimicrobial resistance of gram-negative bacteria isolated from lower respiratory tract specimens of hospitalized patients; [Hastanede yatan hastaların alt solunum yolu örneklerinden izole edilen gram-negatif bakterilerde antimikrobiyal direnç]
(AVES, 2011) Gazi H.; Ecemiş T.; Kurutepe S.; Gürsev N.; Sürücüoǧlu 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.
A comparison of two different fluorochrome stains for the detection of acid-fast bacilli in sputum specimens; [Balgam örneklerinde aside dirençli basil saptanmas? için iki farkl?ı florokrom boyan?ın karş?laşt?ır?ılmas?ı]
(Turkiye Klinikleri, 2011) Oǧuz V.A.; Sezak N.; Öztop A.; Yapar N.; Sürücüoǧlu S.; Yüce A.
Aim: The early diagnosis of active tuberculosis still depends on the presence of acid-fast bacilli (AFB) in stained sputum smears. In this study, our aim was to investigate the efficiency and cost-effectiveness of two different fluorochrome stains. Materials and methods: A total of 1013 sputum specimens were collected from 642 patients. Three smears and cultures were prepared from each specimen. Double-blind and prospective laboratory procedures were performed. Slides were stained with a commercial auramine/acridine orange kit (Stain 1), an in-house preparation of auramine- rhodamine/ KMnO4 (Stain 2) and a Ziehl-Neelsen stain (EZN). Results: Of the 1013 specimens, 101 were culture positive. Among these, AFB was detected in 60 specimens by EZN, in 53 by Stain 1, in 81 by Stain 2. By cultures, the sensitivities and specificities of Stain 2 were 80.1% and 83.8%, respectively, and for Stain 1, 52.4% and 94.6% respectively. There is no significant difference between the costs of these methods. Conclusion: Stain 1 was easy to apply and inexpensive but the sensitivity of Stain 1 was lower than that of Stain 2. However, Stain 2 required longer preparation time, more work, and had a higher risk of exposure to carcinogens. In order to increase the sensitivity of Stain 1, it is suggested that the contents of the prepared Stain 1 kit could be rearranged. In tuberculosis diagnosis, this revised kit may provide practicality in use. © TÜBITAK.
Investigation of bacterial etiology with conventional and multiplex pcr methods in adult patients with community-acquired pneumonia; [Toplum kökenli pnömonisi olan eriǧkin hastalarda konvansiyonel ve multipleks pcr yöntemleriyle bakteriyel etiyolojinin araştirilmas]
(2012) Kurutepe S.; Ecemiş T.; Özgen A.; Blçmen C.; Çelik P.; Özkan S.A.; Sürücüoǧlu S.
Community-acquired pneumonia (CAP) is still a serious life-threatening disease, in which the etiologic agent cannot be identified in more than 50% of patients despite advanced diagnostic methods. The most commonly used methods in the determination of CAP etiology are culture and serological tests. Since early and accurate therapy reduces the mortality in CAP cases, rapid and reliable diagnostic methods are needed. The aim of this study was to determine the bacterial etiology in adult patients with CAP by implementing multiplex polymerase chain reaction/reverse line blot hybridization (M-PCR/RLBH) assay combined with conventional methods. A total of 128 cases (94 were male; age range: 19-81 years, mean age: 58) who were admitted to our hospital and clinically diagnosed as CAP between November 2008 - November 2010, were included in the study. Respiratory samples (sputum and/or broncho-alveolar lavage) obtained from patients were searched by M-PCR/RLBH method (Gen ID®, Autoimmun Diagnostika GmbH, Germany) in terms of the presence of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae. Chlamydia pneumoniae and Legionella pneumophila nucleic acids. The samples were simultaneously inoculated onto 5% sheep blood agar, chocolate agar, haemophilus isolation agar, buffered charcoal yeast extract-selective agar and EMB agar media for cultivation. Serum samples obtained from the cases were tested for IgM and IgG antibodies against C.pneumoniae by microimmunofluorescence (Focus Diagnostic, USA) and against L.pneumophila and M.pneumoniae by indirect immunofluorescence (Euroimmun, Germany) methods. The bacterial etiology was identified in 59 (46.1%) of 128 patients with CAP and a total of 73 pathogens were detected. The leading organism was S.pneumoniae (n= 32, 25%), followed by H.influenzae and M.pneumoniae (n= 9, 7%), gram-negative bacilli (n= 10, 7.8%), M.catarrhalis (n= 6,4.7%), C.pneumoniae (n= 4, 3.2%), L.pneumophila (n= 2, 1.6%) and Staphylococcus aureus (n= 1, 1.4%). Infection with atypical pathogens were detected in 15 (11.7%), and mixed infections in 14 (10.9%) patients. The detection rate of microorganisms (S.pneumoniae, H.influenzae, M.catarrhalis, C.pneumoniae, L.pneumophilia, M.pneumoniae) searched by M-PCR/RLBH method was 41.4% (53/128), while those microorganisms were detected in 23.4% (30/128) of the patients by conventional methods, representing a significant difference (p< 0.05). It was concluded that M-PCR/RLBH method supplemented the determination of bacterial etiology in CAP ca-ses by increasing the rate of detection from 23.4% to 41.4%. The results indicated that empirical treatment of CAP should primarily include antibiotics against S.pneumoniae, M.pneumoniae and H.influenzae in our region.
Molecular diversity of drug resistant Mycobacterium tuberculosis strains in Western Turkey
(Galenos Publishing House, 2012) Sürücüoǧlu S.; Günal S.; Özkütük N.; Biçmen C.; Özsöz A.; Gazi H.; Durmaz R.
Objective: The aim of this study was to investigate the molecular diversity and clonal relationship of drug resistant Mycobacterium tuberculosis strains isolated in Western Turkey. Materials and Methods: A total of 87 strains isolated between 2006 and 2009, eight of which were rifampicin monoresistant and 79 were multidrug resistant, were analyzed with IS6110 RFLP and spoligotyping methods. Results: The results of spoligotyping showed that 7% of the strains were orphans, and 8% were undefined for family in the SpolDB4 database. Major families of the strains were LAM (38%), T (35%), Haarlem (7%), Beijing (2%), S (2%) and U (1%) families. The clustering rate by spoligotyping was calculated as 75%. The most predominant SIT cluster was SIT41 (29%). According to the results of IS6110 RFLP, 71 different patterns of IS6110 were observed. Low copy number was found in 26% of the strains. When the results of two methods were combined, the final clustering rate was calculated as 26%. Conclusions: The genotypical distribution of drug resistant tuberculosis isolates in our region indicates genetic diversity and the clustering rate was found low in our region. However, more comprehensive and long-term molecular epidemiological studies are needed to control the drug resistant strains. © Trakya University Faculty of Medicine.
Levels of cytokines indicative of T cell response in bronchoalveolar lavage of tuberculin skin test-positive children; [Tüberkülin deri testi pozitif çocuklarda bronkoalveoler lavajda T hücre yani{dotless}ti{dotless}ni{dotless}n göstergesi sitokinlerin düzeyleri]
(Aves Yayincilik, 2014) Yüksel H.; Yilmaz Ö.; Onur E.; Sürücüoǧlu S.; Erdin S.; Kirmaz C.
Objectives: The aim of the study was to evaluate the levels of interleukin (IL)-4, IL-10, transforming growth factor-beta (TGF-βb), IL-17, and IL-23 cytokines, which reflect different T lymphocyte responses, in bronchoalveolar lavage (BAL) samples of tuberculin skin test (TST)-positive children. Material And Methods: Twelve children with TST positivity, who underwent flexible videobronchoscopy (FB) to evaluate airway involvement and to obtain BAL to improve diagnostic yield, and 11 control children with negative TST, who underwent FB for other reasons, were enrolled in this case-control study. BAL samples were obtained from all children during the FB procedure. Levels of IL-4, interferon gamma (IFN-γ), IL-10, TGF-βb, IL-17, and IL-23 were measured by the ELISA method. Results: Mean age of the children enrolled in the TST-positive and -negative groups were 8.6 (4.3) vs. 6.8 (4.5), respectively (p=0.35). There was a trend of higher TGF-βb levels in TST-positive children compared with TST-negative children [557.9 (515.3) vs. 386.3 (208.1), respectively, p=0.07]. Mean levels of IL-23 were 39.2 (29.5) in TST-positive children vs. 46.2 (72.3) in TST-negative children (p=0.49). IFN-γ, IL-4, IL-10, and IL-17 levels were not significantly different among the groups (p>0.05 for all). Conclusion: Results of this study suggest that TGF-in BAL fluid of children with TST positivity tends to be higher than that in TST-negative children, which indicates an increased activity of regulatory T lymphocytes that may decrease the Th1 immune response. TGF-might be studied in future research for its potential as a diagnostic modality and immunomodulatory treatment target. © 2014 by Turkish Thoracic Society.
Chronic subcutaneous nodules, plaques and ulcers of the hand
(Medknow Publications, 2017) Ermertcan A.; Özkütük N.; Temiz P.; Çavuşoǧlu C.; Sürücüoǧlu S.
[No abstract available]
Risk of travel associated tuberculosis; [Seyahat ile İlişkili Tüberküloz Riski]
(Ankara Microbiology Society, 2018) Sürücüoǧlu S.
Tuberculosis has spread by human movements throughout history. There have been reports indicating tuberculosis transmission on all travel vehicles, including aircrafts, ground vehicles and vessels until today. However, due to the ever increasing of air transportation and air travelling among countries with low and high tuberculosis incidence, transmission risk especially in aircrafts has become an important issue worldwide. But in many of the studies conducted in this regard, transmission of tuberculosis in aircrafts was found very low. The case of active tuberculosis has not yet been reported. This is due to the fact that in modern aircrafts, there are ventilation systems that provide hepa filtered laminar air flow and change the air 15-20 times per hour. The guidelines for the prevention of tuberculosis infection in aircrafts published by the World Health Organization "Tuberculosis and Air Travel, 2008" and European Centre for Disease Prevention and Control "RAGIDA-TB, 2014" confirm each other. According to these guidelines, air travelling of patients with active pulmonary tuberculosis should be prohibited until smears of two consecutive sputum samples become negative for drug susceptible cases, and cultures of two consecutive of sputum samples become negative for multidrug or extensively drug resistant cases. When it is reported that a tuberculosis patient has travelled by the aircraft, it is recommended that the exposed passengers should be investigated for tuberculosis infection if the flight duration equal to or exceeding eight hours including ground delays and the time elapsed between flight and diagnosis of the case is no longer than three months. Contact screening is only recommended for passengers sitting in the same row, two rows ahead and two rows behind the index case. Tuberculin skin test or interferon gamma release assay can be used for investigation. It is very difficult to determine the risk of tuberculosis transmission in ground vehicles like buses, subways and trains. The reason is that it is often not possible to access the information of the passengers travelling in these vehicles. Because the ventilation systems in ground vehicles are not as reliable as in aircrafts and the crowded environment in the ground vehicles, the risk of tuberculosis transmission is theoretically higher. In modelling studies, the transmission risk in the buses was found to be higher than the trains. In the case of regular travelling with an index case such as school bus riders, the risk increases significantly. The increased human population travelling all over the world nowadays has also raised concerns about travel-related tuberculosis risk. However, because of the limited evidence, it may be more efficient to spend time and resources for the other actions in order to prevent tuberculosis. In this review article, the transmission risk of tuberculosis in vehicles has been discussed. © 2018 Ankara Microbiology Society. All rights reserved.
Recent trends in the antibiotic resistance of Helicobacter pylori in patient with dyspepsia
(Lippincott Williams and Wilkins, 2022) Buran T.; Sürücüoǧlu S.; Kurutepe S.; Gazi H.
The aim of this study was to determine the resistance status and to identify the point mutations conferring resistance to clarithromycin and fluoroquinolones among dyspeptic patients in Manisa, Turkey. The study included a sample of 140 patients with an indication for upper gastrointestinal endoscopy randomly selected from 2100 dyspeptic patients attending to the Gastroenterology and Endoscopy Unit at Manisa Celal Bayar University Hafsa Sultan Hospital between April 2016 and May 2018. A commercially available GenoType Helico DR test was used to detect the presence of Helicobacter pylori and mutations associated with resistance to clarithromycin and fluoroquinolones in biopsy specimens. In total, 116 (82.9%) of 140 biopsies obtained from the same number of dyspeptic patients were positive for H pylori and 82 (approximately 71%) of them harbored resistance mutations in 23SrRNA and/or gyrA. Resistance to clarithromycin, levofloxacin, or both were detected in 43.1% (50/116), 27.6% (32/116), and 16/116 (13.8%) of tested biopsies, respectively. The most common mutation conferring resistance to clarithromycin was A2147G (96%, 48/50). Resistance to fluoroquinolones was frequently due to mutation in codon 91 and the most common mutation detected was D91G (34.4%). Heteroresistance patterns were observed in 48.0% (24/50) of clarithromycin-resistant samples and 28.1% (9/32) of levofloxacin-resistant samples. The resistance rates and detected mutations in this study are in line with the country data. However, to achieve better H pylori eradication and to prevent the spread of multidrug-resistant strains in Turkey, the molecular-based susceptibility tests should be considered routinely. Further studies are needed to determine the various mutations among resistant strains. © 2022 Lippincott Williams and Wilkins. All rights reserved.

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