Browsing by Subject "bacterium culture"
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Item Isolation, characterization and numerical taxonomy of novel oxalate-oxidizing bacteria(2002) Sahin N.; Gökler I.; Tamer A.Ü.The present work is aimed at providing additional new pure cultures of oxalate utilizing bacteria and its preliminary characterization for further work in the field of oxalate-metabolism and taxonomic studies. The taxonomy of 14 mesophilic, aerobic oxalotrophic bacteria isolated by an enrichment culture technique from soil, rhizospheres, and the juice of the petiole/stem tissue of plants was investigated. Isolates were characterized with 95 morphological, biochemical and physiological tests. Cellular lipid components and carotenoids of isolates were also studied as an aid to taxonomic characterization. All isolates were Gram-negative, oxidase and catalase positive and no growth factors were required. In addition to oxalates, some of the strains grow on methanol and/or formate. The taxonomic similarities among isolates, reference strains or previously reported oxalotrophic bacteria were analysed by using the Simple Matching (SSM) and Jaccard (SJ) Coefficients. Clustering was performed by using the unweighted pair group method with arithmetic averages (UPGMA) algorithm. The oxalotrophic strains formed five major and two single-member clusters at the 70-86% similarity level. Based on the numerical taxonomy, isolates were separated into three phenotypic groups. Pink-pigmented strains belonged to Methylobacterium extorquens, yellow-pigmented strains were most similar to Pseudomonas sp. YOx and Xanthobacter autotrophicus, and heterogeneous non-pigmented strains were closely related to genera Azospirillum, Ancylobacter, Burkholderia and Pseudomonas. New strains belonged to the genera Pseudomonas, Azospirillum and Ancylobacter that differ taxonomically from other known oxalate oxidizers were obtained. Numerical analysis indicated that some strains of the yellow-pigmented and nonpigmented clusters might represent new species.Item Emergence of phenotypic resistance to ciprofloxacin and levofloxacin in methicillin-resistant and methicillin-sensitive Staphylococcus aureus strains(Elsevier, 2003) Limoncu M.H.; Ermertcan S.; Çetin C.B.; Cosar G.; Dinç G.The emergence of phenotypic resistance to ciprofloxacin and levofloxacin in methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MRSA) strains was studied. Twenty MRSA and 77 methicillin-sensitive S.aureus (MSSA) strains susceptible to both quinolones were investigated for resistance after single step or serial passages. No growth of 20 MRSA strains was observed at 4×MIC of levofloxacin after 48 h incubation, but 4 of 77 (5%) MSSA strains grew at the same concentration. At 4×MIC concentration of ciprofloxacin, 10 MSSA (13%) and five MRSA (25%) strains were grown. In the serial passages of MRSA strains, resistance to ciprofloxacin was 75 and 5% for levofloxacin by the third passage. In the seventh passage this resistance was 100 and 15%, respectively. In MSSA strains, resistance to ciprofloxacin was 75 and 19% to levofloxacin at the third passage and at the seventh passage, 100 and 61%, respectively. Emergence of ciprofloxacin resistance was more common and developed more rapidly than resistance to levofloxacin in both MRSA and MSSA strains. © 2003 Elsevier Science B.V. and the International Society of Chemotherapy. All rights reserved.Item Acrodermatitis continua of Hallopeau: Was it an outcome of a surgical trauma or initially misdiagnosed as onychomycosis? [8](2003) Şahin M.T.; Öztürkcan S.; Türel A.; Kandiloǧlu A.R.[No abstract available]Item Maternal carriage and antimicrobial resistance profile of group B Streptococcus(Urban und Vogel, 2003) Arisoy A.S.; Altinişik B.; Tünger Ö.; Kurutepe S.; Ispahi Ç.Background: The aim of this study was to determine the prevalence of group B Streptococcus (GBS) colonization and to evaluate the antimicrobial resistance profile in women in the third trimester of pregnancy. Materials and Methods: A total of 310 pregnant women, referred in weeks 35 to 37 of gestation, were screened for GBS colonization during a 10-month period. Samples were collected from the vagina and the rectum. Results: The colonization rate was 10.6% and 22 women (66.7%) had both positive vaginal and rectal cultures. Rates of GBS colonization were significantly Lower in patients aged 24 years or older and in those with a third or later pregnancy. None of the isolates were resistant to penicillin and ampicillin, whereas 21.2% and 9.1% showed resistance to erythromycin and clindamycin, respectively. Conclusion: Screening and antimicrobial susceptibility testing of GBS during pregnancy are important to guide appropiate therapy.Item The effect of circumcision status on periurethral and glanular bacterial flora(2004) Günşar C.; Kurutepe S.; Alparslan O.; Yilmaz Ö.; Daǧlar Z.; Şencan A.; Genç A.; Taneli C.; Mir E.Introduction: Circumcision is a historical operation which is still performed for different purposes. The aim of this study is to investigate the changes in periurethral and glanular sulcus flora due to circumcision to determine the role of circumcision on urinary tract infections (UTIs). Patients and Methods: Fifty patients who were circumcised for social-religious reasons between January 2000 and January 2001 were evaluated in this prospective study. Two swabs were taken from the periurethral and glanular sulcus regions both just before circumcision and 4 weeks after, and the bacteria cultured were recorded. Results: We isolated pathogenic bacteria in the periurethral region of 32 (64%) patients (enterococci in 14 cases; Escherichia coli in 12 cases) before circumcision, and this number decreased to 5 (10%) after circumcision. Similarly, pathogenic bacteria were cultured from the glanular sulcus swabs of 33 (68%) patients (enterococci in 14 cases; E. coli in 10 cases), as well as coagulase-negative staphylococci in another 15 patients before circumcision. Following circumcision, we detected pathogenic bacteria in the glanular cultures of only 4 cases, whereas 40 children had non-pathogenic skin flora. Only 1 of 5 children with history of UTIs (n = 1) and retractable phimosis (n = 4) had periurethral pathogenic bacteria (Proteus spp.) in the post-circumcision period. The differences between pre- and post-circumcision values of the pathogenic bacterial colonizations were statistically significant in both groups sampled (p < 0.05). Conclusion: Non-circumcised patients have similar pathogenic bacterial colonizations in the periurethral and the inner preputial regions, although they have no phimosis. The origin of periurethral flora should be the deeper preputial regions. The flora greatly changed with skin commensals after circumcision. Circumcision might be beneficial from this point of view. Copyright © 2004 S. Karger AG, Basel.Item Antimicrobial susceptibility of bacterial pathogens in the oropharynx of healthy school children in Turkey(2004) Gazi H.; Kurutepe S.; Sürüoǧlu S.; Teker A.; Özbakkaloglǔ B.Background & objectives: Information on oropharyngeal carriage rates of Streplococcus 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. pneumoniae 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 β-lactamase, except two isolates interpreted as β-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 β-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.Item Oropharyngeal carriage and penicillin resistance of Neisseria meningitidis in primary school children in Manisa, Turkey(Academy of Medicine Singapore, 2004) Gazi H.; Surucuoglu S.; Ozbakkaloglu B.; Alkcali S.; Ozkutuk N.; Degerli K.; Kurutepe S.Introduction: To determine the oropharyngeal carriage rates and serogroups of Neisseria meningitidis in primary school children in Manisa, Turkey as well as the prevalence and penicillin resistance of AC meningitidis. Materials and Methods: Throat swabs obtained from 1128 children were cultured and recovered organisms were tested by disk diffusion method and the E-test for antimicrobial susceptibilities. Results: The carriage rate of N. meningitidis in our region was 6.2% (71 strains) and the serogroups identified were serogroups A (28.1%), B (22.5%), C (35.2%), D (2.8%) and W-135 (11.2%). Penicillin resistance was found in 16 strains (22.5%), while beta-lactamase activity was found in none. Conclusions: The carriage rate of N. meningitidis and serogroups are similar to the rates reported in other countries. Continued surveillance of meningococci for antimicrobial resistance will allow early detection of changes in susceptibility patterns that might affect recommendations for chemoprophylaxis as well as for treatment.Item Drug-resistant pulmonary tuberculosis in western Turkey: Prevalence, clinical characteristics and treatment outcome(King Faisal Specialist Hospital and Research Centre, 2005) Surucuoglu S.; Ozkutuk N.; Celik P.; Gazi H.; Dinc G.; Kurutepe S.; Koroglu G.; Havlucu Y.; Tuncay G.Background: Although high antituberculosis (anti-TB) drug resistance rates have been reported in Turkey, the clinical characteristics and implications for the outcome of anti-TB treatment have not been fully investigated. We determined the prevalence of anti-TB drug resistance and examined demographic data, clinical characteristics and treatment outcome in relation to patterns of resistance. Methods: From the TB case registry of a university hospital and the two largest dispensaries in Manisa city, we identified all pulmonary TB cases with a culture-proven definitive diagnosis and antimicrobial susceptibility results for a 7-year period. We collected and analyzed demographic and clinical data and information on treatment outcome for those cases in relationship to anti-TB drug resistance. Results: Of 355 M. tuberculosis strains, 71.5% were susceptible to streptomycin, isoniazid, rifampicin and ethambutol. Any drug resistance and multi-drug resistance (MDR) rates were 21.1% and 7.3% and were higher in males (53% and 9%, respectively) than in females (22% and 1%, respectively). Drug resistance was significantly higher in old cases (acquired drug resistance) vs new cases (primary drug resistance), and was associated with treatment failure (P<0.001). The prevalence of MDR was significantly higher in the old cases (22.4%) than in the new cases (4.4%) (P<0.001). Symptoms, radiographic findings, associated diseases, and sputum smear positivity were unrelated to the development of resistance. The prevalence of any drug resistance and MDR was significantly higher in those with treatment failure than in patients with treatment success. Conclusion: High resistance rates, particularly for acquired MDR, indicate a need for improvement in the TB control programme in our region.Item Evaluation of antimicrobial activity of some endemic Scrophulariaceae members from Turkey(2005) Dulger B.; Ugurlu E.The methanol extracts obtained from endemic Scrophulariaceae members Verbascum protractum Fenel ex Tchihat., Verbascum bellum Hub.-Mor., Verbascum dalamanicum Hub.-Mor., Scrophularia mersinensis Lall, Scrophularia cryptophila Boiss. & Heldr., Pedicularis olympica Boiss., and Veronica lycica E. Lehm. have been investigated for their antimicrobial activity. Antimicrobial activity was determined with Escherichia coli ATCC 11230, Staphylococcus aureus ATCC 6538P, Klebsiella pneumoniae UC57, Pseudomonas aeruginosa ATCC 27853, Proteus vulgaris ATCC 8427, Bacillus cereus ATCC 7064, Mycobacterium smegmatis CCM 2067, Listeria monocytogenes ATCC 15313, Micrococcus luteus CCM 169, Candida albicans ATCC 10231, Rhodotorula rubra DSM 70403, and Kluyveromyces fragilis ATCC 8608 by the disk diffusion method. The extracts of all Scrophulariaceae members used in this study had strong antimicrobial activity against the Gram-positive bacteria and yeast cultures. © 2005 Taylor & Francis Ltd.Item A case of traumatic ulceration mimicking spinocellular carcinoma; [Spinosellüler karsinomu taklit eden skalp yerleşimli bir travmatik ülser](Turkiye Klinikleri, 2005) Şahin M.T.; Türel Ermertcan A.; Öztürkcan S.; Türkdoǧan P.In this article, it was aimed to show that ulcerations can develop not only following circulatory insufficiency, localized pressure, granulomatous degeneration, malignant tumors and local injections, but following exogenous traumas to skin as well. We present a 65-year-old male with a history of ulcer development on his nape following a cranial trauma 6 weeks before. A biopsy was taken to differentiate it from squamous cell carcinoma. Histopathologic examination revealed no tumor cell areas. Bacteriologic culture from ulcer floor revealed enterobacter. By enacting a combined systemic therapy with ciprofloxacin and gentamycin in addition to topical antiseptic therapy, the ulcer underwent complete remission in 15 days. This case is presented not only to draw attention to the possible clinical similarities between traumatic ulceration and squamous cell carcinoma, but also to emphasize the importance of differential diagnosis in the proper treatment of ulcers. Copyright © 2005 by Türkiye Klinikleri.Item The effect of acid adaptation conditions on heat resistance of Escherichia coli O157: H7(2005) Tosun H.; Gönül Ş.A.The objective of this study was to determine the effect of acid adaptation conditions on heat resistance of E. coli O157: H7 932. E. coli O157: H7 was adapted to acid by exposing the cells to pH 4.5 (2h), pH 5.0 (1h), and pH 5.5 (1 h) in tryptic soy broth. D and z values of the acid adapted and control cultures at 54°C, 56°C, and 58°C were determined in E buffer. The heat resistance of E. coli O157: H7 increased significantly (p<0.05) after acid adaptation at pH 4.5 or pH 5.0. E. coli O157: H7 adapted to acid at pH 4.5 for 2 h had the highest D values at all temperatures tested (20.3-10.7-3.3 min) while D values of culture adapted to acid at pH 5.0 for 1 h were 18.2, 7.9, and 2.6 min at 54°C, 56°C and 58°C, respectively. Heat resistance of culture adapted to acid at pH 5.5 for 1 h and the control culture was not significantly different (P<0.05). Culture adapted to acid at pH 4.5 had the highest z value (5.10°C), whereas control culture had the lowest z value (4.33°C). This study showed that the magnitude of heat tolerance changed with the adaptation pH and at low adaptation pH, E. coli O157: H7 showed maximum heat resistance. Acid adaptation at pH 4.5 or 5.0 provides E. coli O157: H7 with cross-protection against heat treatments, and that this factor must be considered to estimate this pathogen's thermal tolerance accurately.Item Does the MGIT 960 system improve the turnaround times for growth detection and susceptibility testing of the Mycobacterium tuberculosis complex? [1](2006) Somoskovi A.; Clobridge A.; Larsen S.C.; Sinyavskiy O.; Surucuoglu S.; Parsons L.M.; Salfinger M.[No abstract available]Item Microbiological results of bronchoalveolar lavage that was performed for opportunistic pulmonary infections; [Firsatçi pulmoner infeksiyon ön tanisiyla yapilan bronkoalveoler lavajin mikrobiyolojik sonuçlari](2006) Gülcü A.; Sevinç C.; Esen N.; Kilinç O.; Uç E.S.; Itil O.; Çimrin A.H.; Kömüs N.; Şener G.; Akkoçlu A.; Gülay Z.; Yücesoy M.Between 2001-2002; in 62 cases, 33 (53%) male, 29 (47%) female, mean age 51.4 ± 18.1 years) bronchoalveolar lavage (BAL) was performed for diagnosis of opportunistic pulmonary infection and specimens were evaluated for results of microbiological examinations. There was hematological malignancy in 18 (29%) and solid organ malignancy in 13 (21%) cases. Thirty-one (50%) cases were immuncompromised for reasons other than malignancy. By endoscopic evaluation endobronchial lesion was seen in 2 (3%) cases, indirect tumor signs were seen in 2 (3%) cases and signs of infection were seen in 11 (18%) cases. Fortyseven (76%) cases were endoscopically normal. Acid-fast bacilli (AFB) direct examination was positive in 3 (5%) cases. In 4 (6%) cases mycobacterial culture was positive, Mycobacterium tuberculosis-polymerase chain reaction (PCR) was also positive in these four cases. Examination of Gram-stained smears for bacteria was associated with infection in 14 (23%) cases. Bacteriologic cultures were positive for single potential pathogen in 10 (16%) cases, and for mixed pathogens in 7 (11%) cases for a total number of 17 (27%). Fungal cultures were positive in 3 (5%) cases all of which had hematological malignancy. As a result in 24 (39%) cases microbiological agent of infection is determined: in four mycobacteria, in 17 bacteria other than mycobacteria and in three fungi.Item Prognostic value of initial antithrombin levels in neonatal sepsis(2007) Ersoy B.; Nehir H.; Altinoz S.; Yilmaz O.; Dundar P.E.; Aydogan A.Objectives: We determined whether initial antithrombin (AT) levels help in diagnosis and prognosis of neonatal sepsis. Methods: Sepsis was diagnosed according to clinical and laboratory findings and positive culture results in 34 of the 54 newborns who presented to the hospital with suspected sepsis. Between AT levels and hematological parameters (fibrinogen levels, prothrombin time (PT), activated partial thromboplastin time (aPTT) and liver function tests), these were correlated each other and with outcome of the babies. Results: Initial AT and fibrinogen levels were significantly lower in newborns with sepsis compared to control (P<0.05). Initial AT levels were lower in the ones who developed disseminated intravascular coagulation (DIC) compared to those without DIC (P <0.05). Initial AT levels were significantly lower in newborns who died as compared to survivors (P <0.05). Sensitivity of AT was highest at 15 mg/dL for prognosis in neonatal sepsis (sensitivity:92.3%, specificity:61.9%, positive predictive value : 61.9%, negative predictive value: 61.9%). Conclusion: Lower initial AT levels in neonatal sepsis are associated with a severe disease and increased mortality. It may be useful in predicting clinical outcome in neonatal sepsis.Item A case of primary pulmonary tuberculosis presenting as foreign body aspiration(IOS Press, 2007) Ikizoǧlu T.; Yilmaz O.; Özkol M.; Söǧüt A.; Yüksel H.An 18-month-old child was hospitalized with presumptive diagnosis of foreign body aspiration. Chest radiography revealed atelectasis in the right lower lobe. Foreign body was not seen at rigid bronchoscopy. Tuberculin skin test was 11 mm with one scar of Bacillus Calmette-Guerin vaccine. Computerized tomography of thorax revealed conglomerating lymphadenopathy in the right hilus and calcified lymphadenopathy as well as pneumonic consolidation of the right lower lobe. Tuberculosis was diagnosed based on his tuberculin skin test and thorax computerized tomography. This case is presented to emphasize that tuberculosis should be included to the differential diagnosis of children that present with signs and symptoms of foreign body aspiration and atelectasis. © 2007 IOS Press. All rights reserved.Item 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.Item 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.Item Pott's disease with scrofuloderma and psoas abscess misdiagnosed and treated as hidradenitis suppurativa(2011) Ermertcan A.T.; Öztürk F.; Gençoǧlan G.; Nanir I.; Özkütük N.; Temiz P.A 29-year-old man with painless ulcers on the lumbar and inguinal regions associated with purulent discharge of 1.5 years' duration presented to our outpatient clinic. Dermatological examination revealed palpable nodules, discharging sinuses and scars on the left lumbar, gluteal and inguinal regions. According to the clinical, histopathological, scintigraphy, and magnetic resonance imaging findings as well as mycobacteriological examinations, the patient was diagnosed with Pott's disease with scrofuloderma and psoas abscess. Herein, we present an interesting case of Pott's disease with scrofuloderma and psoas abscess mistreated as hidradenitis suppurativa for a long time. © 2011 Informa Healthcare USA on behalf of Informa UK Ltd.Item Antituberculosis drug resistance patterns in adults with tuberculous meningitis: Results of haydarpasa-iv study(BioMed Central Ltd., 2015) Senbayrak S.; Ozkutuk N.; Erdem H.; Johansen I.S.; Civljak R.; Inal A.S.; Kayabas U.; Kursun E.; Elaldi N.; Savic B.; Simeon S.; Yilmaz E.; Dulovic O.; Ozturk-Engin D.; Ceran N.; Lakatos B.; Sipahi O.R.; Sunbul M.; Yemisen M.; Alabay S.; Beovic B.; Ulu-Kilic A.; Cag Y.; Catroux M.; Inan A.; Dragovac G.; Deveci O.; Tekin R.; Gul H.C.; Sengoz G.; Andre K.; Harxhi A.; Hansmann Y.; Oncu S.; Kose S.; Oncul O.; Parlak E.; Sener A.; Yilmaz G.; Savasci U.; Vahaboglu H.Background: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM. Methods: Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line antituberculosis drugs, streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). Results: Twenty of 142 isolates (14.1 %) were resistant to at least one antituberculosis drug, and five (3.5 %) were resistant to at least INH and RIF, [multidrug resistant (MDR)]. The resistance rate was 12, 4.9, 4.2 and 3.5 % for INH, SM, EMB and RIF, respectively. The monoresistance rate was 6.3, 1.4 and 0.7 % for INH, SM and EMB respectively. There was no monoresistance to RIF. The mortality rate was 23.8 % in fully susceptible cases while it was 33.3 % for those exhibiting monoresistance to INH, and 40 % in cases with MDR-TBM. In compared to patients without resistance to any first-line drug, the relative risk of death for INH-monoresistance and MDR-TBM was 1.60 (95 % CI, 0.38-6.82) and 2.14 (95 % CI, 0:34-13:42), respectively. Conclusion: INH-resistance and MDR rates seemed not to be worrisome in our study. However, considering their adverse effects on treatment, rapid detection of resistance to at least INH and RIF would be most beneficial for designing anti-TB therapy. Still, empiric TBM treatment should be started immediately without waiting the drug susceptibility testing. © 2015 Senbayrak et al.Item Henoch–Schonlein purpura, post-streptococcal glomerulonephritis and acute rheumatic carditis after Group A β-haemolytic streptococcal infection(Taylor and Francis Ltd., 2018) Arslansoyu Çamlar S.; Soylu A.; Akil İ.; Ünlü M.; Coşkun Ş.; Ertan P.; Kavukçu S.Besides association with acute rheumatic fever (ARF) and acute glomerulonephritis (APSGN), in up to 40% of cases, Group A β-haemolytic streptococcal (GABHS) infections are also implicated as a trigger for Henoch–Schonlein purpura (HSP). A 7-year-old girl with GABHS throat infection who developed HSP, APSGN and rheumatic carditis is reported. She presented with palpable purpura and arthritis in both ankles and later developed carditis characterised by mitral/aortic regurgitation and glomerulonephritis characterised by mixed nephritic/nephrotic syndrome. She had a raised anti-streptolysin titre (ASOT), blood urea nitrogen and creatinine and hypocomplementaemia (C3), and renal biopsy demonstrated endocapillary and extracapillary proliferative glomerulonephritis with crescents. Immunofluorescence microscopy demonstrated a ‘full house’ of immunoglobulin and complement, viz. IgA + 2, IgG + 3, IgM + 2, C3c + 1, Clq + 2 with predominantly IgG deposition. One week earlier, her 4-year-old sister had presented to another hospital with HSP complicated by microscopic haematuria, nephrotic-range proteinuria and gastro-intestinal involvement, and with raised ASOT and low C3 levels. Although HSP has been associated with either ARF or APSGN, this is the first case of a child with HSP, ARF and APSGN in combination. © 2017 Informa UK Limited, trading as Taylor & Francis Group.