{"title":"[Investigation of Virulence Genes and Carbapenem Resistance Genes in Hypervirulent and Classical Isolates of Klebsiella pneumoniae Isolated from Various Clinical Specimens].","authors":"Merve Yürek, Nural Cevahir","doi":"10.5578/mb.20239915","DOIUrl":"https://doi.org/10.5578/mb.20239915","url":null,"abstract":"<p><p>Klebsiella pneumoniae is a global pathogen that can cause hospital-acquired and community-acquired infections and is known for its resistance to antibiotics. The pathotype, which is defined as hypervirulent K.pneumoniae (hvKp) is more lethal than classical K.pneumoniae (cKp) isolates and causes many community-acquired infections such as liver abscess, endophthalmitis, pneumonia in healthy young adults. There are no clear clinical or microbiological criteria to define hvKp. String test showing hypermucoviscosity and the iucA gene encoding aerobactin, a siderophore, were used to demonstrate hypervirulence. In this study, it was aimed to investigate the presence of various virulence genes and carbapenem resistance genes in the isolates of K.pneumoniae isolated from various clinical samples in our laboratory and classified as classical and hypervirulent by string test and also to detect the presence of various virulence and carbapenem resistance genes in hvKp isolates. Presence of four virulence genes (fimH-1, rmpA, magA, iucA), K1-K2 serotypes in all isolates and five carbapenem resistance genes (blaOXA-48, blaKPC, blaIMP, blaVIM, blaNDM-1) in carbapenem resistant isolates were investigated with polymerase chain reaction (PCR) method. Forty-five percent of the isolates were defined as hvKp and 55% as cKp. The fimH-1 gene was found to be positive in 94% of the isolates, the iucA gene in 37%, the magA gene (K1) in 34%, the rmpA gene in 5%, and the K2 serotype in 3% of the isolates. iucA gene was positive in 68.9% of hvKp isolates and 10.9% of cKp isolates, and the presence of iucA gene in hvKp isolates was statistically significant compared to cKp isolates (p<0.05). magA gene and K1 serotype were detected in 28.9% of hvKp isolates and 38.2% of cKp isolates. Although the magA gene ratio was high in cKp isolates, this difference was not statistically significant (p> 0.05). fimH-1 gene was found positive in 93.3% of hvKp isolates and 94.5% of cKp isolates. The rmpA gene was positive in 8.9% of hvKp isolates and 1.8% of cKp isolates. The K2 serotype was positive in 4.4% of hvKp isolates and 1.8% of cKp isolates. Although there was no statistical difference in antibiotic susceptibility between hvKp and cKp isolates; ceftriaxone, cefuroxime, ceftazidime, amikacin, cefoxitin, ertapenem, cefuroxime axetil were found to be more sensitive in hvKp isolates. Ciprofloxacin and trimethoprim sulfamethoxazole were found to be more sensitive in hvKp isolates than cKp isolates, and the difference was statistically significant (p<0.05). Although gentamicin, amoxicillin, piperacillintazobactam were not statistically significant in the cKp group, they were more sensitive than the hvKp group (p> 0.05). Carbapenem resistance were found to be 65.7% in cKp and 34.3% in hvKp isolates. Although not statistically significant, hvKp isolates were found to be more sensitive to carbapenems. The most common gene among 35 carbapenem resistant isolates was blaOXA-48 detected in 2","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 2","pages":"188-206"},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Müge Hacer Özkarataş, Nazlı Arslan, Nuran Esen, Ayşe Aydan Özkütük
{"title":"[Evaluation of Antimicrobial Susceptibilities of Rapidly Growing Mycobacteria].","authors":"Müge Hacer Özkarataş, Nazlı Arslan, Nuran Esen, Ayşe Aydan Özkütük","doi":"10.5578/mb.20239917","DOIUrl":"https://doi.org/10.5578/mb.20239917","url":null,"abstract":"<p><p>Infections related to the rapidly growing mycobacteria (RGM), which are common in the environment, have clinical significance as they can affect both immunocompromised and immunocompetent patients. Treatment of RGM related infections is difficult, because they are resistant to many of the first-line tuberculosis agents, require a long-term multiple drug regimen, which is costly, and is associated with drugrelated toxicities. The aim of this study was to investigate the in vitro antimicrobial susceptibility profiles of RGM isolated in Dokuz Eylül University Hospital and also to reveal epidemiological data. A total of 58 isolates [(Mycobacterium fortuitum (n= 35), Mycobacterium abscessus (n= 19) and Mycobacterium chelonae (n= 4)], which were isolated in Dokuz Eylül University Hospital between 2013 and 2018, were subjected to in vitro testing for nine antimicrobial agents (amikacin, cefoxitin, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, moxifloxacin and tobramycin) with the broth microdilution method recommended by the Clinical and Laboratory Standards Institute (CLSI). For M.abscessus; 73.68% of the isolates were found susceptible to amikacin; 73.68% of isolates were susceptible to clarithromycin at early reading and only 21.05% of them remained susceptible at late reading time. No resistance to imipenem were observed. M.abscessus isolates were highly resistant to tobramycin, doxycycline and fluoroquinolones. Antibiotic susceptibility testing of M.chelonae isolates demonstrated 100% susceptibility for amikacin, clarithromycin and tobramycin. No resistance to linezolid, imipenem and moxifloxacin were observed. None of the isolates were susceptible to cefoxitin. Ciprofloxacin and doxycycline also showed poor in vitro activity against M.chelonae isolates. For M.fortuitum clarithromycin susceptibility decreased from 32.35% to 2.94% after an additional incubation until 14 days. All tested isolates of the M.fortuitum were susceptible to amikacin, ciprofloxacin and moxifloxacin. None of the M.fortuitum isolates exhibited resistance to cefoxitin and imipenem. Most of the M.fortuitum isolates were resistant to tobramycin and doxycycline. When the results were evaluated together, RGM isolates in this study were highly susceptible to amikacin; and were highly resistant to doxycycline. In conclusion, this study supported that the status of antimicrobial susceptibilities were different between species and also showed the importance for hospitals to know susceptibility patterns of isolates in their region. It should be noted that accurate species determination is critical for treatment as well as susceptibility status of rapidly growing mycobacteria to the antimicrobials in use.</p>","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 2","pages":"220-237"},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Efficacy of Homologous and Heterologous Vaccine Applications on SARS-CoV-2 Omicron Variant: Cohort of Manisa Celal Bayar University Healthcare Workers].","authors":"Kübra Çiçek, Yunus Özkaya, Erhan Eser, Zeynep Ceyda Buran, Zeynep Öykü Öztürk Arıkan, Sinem Akçalı, Pınar Erbay Dündar, Beyhan Cengiz Özyurt, Şebnem Şenol Akar, Deniz Özer, Ferya Karadağ Yalçın","doi":"10.5578/mb.20239918","DOIUrl":"https://doi.org/10.5578/mb.20239918","url":null,"abstract":"<p><p>This study was aimed to determine the efficacy of homologous (only CoronaVac or only Pfizer-BioNTech) and heterologous (CoronaVac and Pfizer-BioNTech) vaccines during the period when the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron variant was dominant in Türkiye. Coronavirus disease-2019 (COVID-2019) infection was confirmed by reverse transcriptase polymerase chain reaction and data on vaccination status against COVID-19 were evaluated during the period of 15 January 2022-1 May 2022 when the SARS-CoV-2 Omicron variant was dominant among 1854 employees followed in the SARS-CoV-2 Vaccine Cohort of Manisa Celal Bayar University (MCBU) Hospital Health Workers. Two separate reference groups were used in the evaluation of vaccine efficacy: those who were never vaccinated and those who received only two doses of CoronaVac. The efficacy of homologous and heterologous vaccine models was evaluated with relative risks and attributable risk percentages. MS Excel, SPSS 23.0 and STATA 14.1 package programs were used for statistical analysis. The mean age of the participants was 36.6 ± 10.0. During the period from January 15th to May 1st 2022, 372 hospital workers were infected with COVID-19. Taking the never vaccinated as the reference group, the most effective model was found to be only the three or more doses of the Pfizer-BioNTech primary vaccination model (85.8%, 95% CI= 40.7-96.6). Models consisting of a single dose of CoronaVac (6.5%, 95% CI= -56.3-44.2) or a single dose of Pfizer-BioNTech (17.7%, 95% CI= -30.2-48.0) booster dose administered after two doses of primary CoronaVac vaccination was not found to be effective against the SARS-CoV-2 Omicron variant. When only two doses of primary CoronaVac vaccination model was taken as the reference group, the model consisting of two doses CoronaVac followed by two Pfizer-BioNTech booster doses was effective as 38.4% (95% CI= 15.4-55.3), whereas three doses of Pfizer-BioNTech booster model was effective as 56.4% (95% CI= 33.9-71.3). To conclude, none of the models other than the homologous or heterologous vaccine models containing at least three doses of Pfizer-BioNTech vaccine were effective compared to those unvaccinated. Compared with those who received only two doses of primary Coronavac, models with at least three doses of Pfizer-BioNTech reminder doses were more effective against the Omicron variant than other models.</p>","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 2","pages":"238-251"},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hikmet Eda Alışkan, Özlem Öğüç Şanlı, Filiz Aka Bolat, Didem Alkaş Yağınç, Uğur Toprak
{"title":"[Determination of Human Papilloma Virus (HPV) Genotype Prevalance and Distrubution in Adana: A Hospital-Based Study Between 2014-2021].","authors":"Hikmet Eda Alışkan, Özlem Öğüç Şanlı, Filiz Aka Bolat, Didem Alkaş Yağınç, Uğur Toprak","doi":"10.5578/mb.20239910","DOIUrl":"https://doi.org/10.5578/mb.20239910","url":null,"abstract":"<p><p>Cervical cancer is the fourth most common cancer among women all over the world. It is accepted that cervical cancer is highly related to the HPV. The International Agency for Research on Cancer (IARC) has classified 13 HPV types as group 1 carcinogens (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 66), which are commonly referred to as high risk-HPVs (hr-HPVs). Among these, hr-HPV-16 is undoubtedly the most carcinogenic based in the burden of cervical cancer (CC) and its precursor lesions. In our study, we analyzed retrospectively the data of a total of 2329 female patients who applied to the obstetrics and gynecology outpatient clinic of our hospital over a seven-year-period, whose cervical smear were carried out by the polymerase chain reaction (PCR) and cytology. In this study, it was aimed to determine the data of of HPV prevalence in our region during the seven-year-period from April 2014 to April 2021 and the most common genotypes and to interpret them together with the cervical smears cytology and biopsy results if it is available. HPV 3, 6, 11, 16, 18, 21, 26, 31, 33, 35, 39, 40, 42, 45, 51, 52, 53, 54, 55, 56, 58, 59, 61, 62, 66, 67, 68, 70, 72, 73, 81, 82, 83, 84 were identified by using linear array HPV genotyping test (Roche Diagnostics, Switzerland) from April 2014 to October 2017. HPV genotypes were identified by using HPV Genotypes 14 Real-TM Quant (Qiagen, Germany) between October 2017 and April 2021. This method detected HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68. The data were analyzed using IBM SPSS Statistics (Version 25.0) predictive analytics software. Continuous variables are indicated as mean ± standard deviation, and discrete variables are indicated as number [percentage (%)]. Chi-square test is used to investigate dependencies between variables. All analyzes were evaluated to provide 95% confidence level and 80% test power. p<0.05 was accepted as significant for the analysis results. Out of 2329 patients, 1283 were found to be HPV negative (54.6%) and the others were found to be HPV positive (45.4%) by using real-time PCR in the cervical smears. It was detected that out of 1046 HPV positive patients, 585 of them (55.9%) had one HPV genotype and 461 of them (44.1%) had more than one HPV genotypes. As we divided all of the patients into two groups as <30 (Group I) ve > 30 (Group II) according to age range, HPV positivity was found 134/296 (45.2%) in Group I and 912/2033 (44.8%) in Group II. When we compared the HPV positive/negative results of Groups I and II by using chi-square test, no significant difference was found between the two age groups in terms of HPV positivity (p= 0.894). In our study, the most common HPV types were HPV 16 (14.2%), HPV 68 (8.2%), HPV 56 (8.2%), HPV 52 (7.1%), HPV 51 (6.8%), HPV 31 (6.5%), HPV 66(6.1%), HPV 39 (5.8%) and HPV 18 (5.6%) among the women with normal and abnormal cytology in the cervical smears. ASC-US was the most common abnormal epithelia","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 1","pages":"119-133"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10531355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Serpil Ölmez, Barış Otlu, Burçin Şener, Banu Sancak
{"title":"[The Importance of Gram-stained Smears in the Diagnosis of Nocardia Infections].","authors":"Serpil Ölmez, Barış Otlu, Burçin Şener, Banu Sancak","doi":"10.5578/mb.20239909","DOIUrl":"https://doi.org/10.5578/mb.20239909","url":null,"abstract":"<p><p>Nocardia species are low virulence bacteria found in nature. They can be an infectious agent, especially in patients with risk factors such as underlying immunosuppression, chronic lung disease, and malignancy. They can be easily overlooked because they are not seen frequently and has no pathognomonic symptoms. With this study, it was aimed to draw attention to the importance of microscopic examination of Gram-stained smears in the diagnosis of Nocardia infections in routine microbiology laboratories. Cases in which Nocardia spp. were detected in their clinical samples between November 2014-December 2015 in Hacettepe University Medical Faculty Hospital were included in the study. In the direct microscopic examination of Gram-stained smears of the samples arriving to the laboratory, the incubation periods of the cultures of the samples compatible with Nocardia spp. were extended. Then relevant colonies were identified by conventional microbiological methods and also by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS, bioMerieux, France) automated system. Species-level identification of Nocardia isolates was performed by 16S rRNA gene sequence analysis. To demonstrate the genetic relationship between Nocardia isolates, pulsed-field gel electrophoresis (PFGE) was performed. In vitro susceptibility of the isolates against amoxicillin-clavulanate (AMC), linezolid, moxifloxacin, trimethoprim-sulfamethoxazole (TMP-SXT), amikacin, imipenem, clarithromycin, cefepime, cefotaxime, ceftriaxone, and ciprofloxacin was determined using the gradient strip method (E-test). A total of 19 Nocardia spp. strains were isolated from eight patients. Four cases exhibited repeated growth of Nocardia spp. up to a period of nine months. The most frequently isolated species was N.cyriacigeorgica, which was identified in four cases. Other species isolated from patients were N.asteroides, N.transvalensis, N.farcinicia, and N.asiatica/arthritidis. When the results obtained with DNA sequence analysis and MALDI-TOF MS were compared, 16 (84.2%) of 19 isolates were correctly identified to the genus level and 9 (47.4%) to the species level with MALDI-TOF MS, while three (15.8%) isolates could not be identified, and seven (36.8%) isolates were misidentified. According to the PFGE results, it was determined that the strains isolated from the same patient were genetically identical. All isolates were susceptible to amikacin, cefepime, cefotaxime, ceftriaxone, imipenem, linezolid, and except one isolate to TMP-SXT. Among the study isolates, the most common resistance was against ciprofloxacin (62.5%), followed by clarithromycin (37.5%). N.cyriacigeorgica was determined as the most frequently detected and the most resistant species to antibiotics in the study population. Direct microscopic examination of clinical specimens is one of the most valuable methods for the identification of Nocardia-type bacteria, which is difficult to isolate in","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 1","pages":"108-118"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10531352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Evaluation of Ex Vivo Cultivation Potentials of Trypanosoma cruzi, Leishmania tropica ve Toxoplasma gondii Parasites in J774, Vero and HeLa Cell Lines].","authors":"Ahmet Yıldırım, Ahmet Özbilgin, Kor Yereli","doi":"10.5578/mb.20239906","DOIUrl":"https://doi.org/10.5578/mb.20239906","url":null,"abstract":"<p><p>Three obligate intracellular protozoan parasite species, namely Trypanosoma cruzi, Leishmania tropica and Toxoplasma gondii, causative agents of Chagas disease, Leishmaniasis and toxoplasmosis, respectively, which are responsible for significant morbidity and mortality and reside in macrophage cells, affect more than half of the world's population in connection with socio-economic and geographical factors and also causes neglected parasitic diseases of increasing importance. This study aimed to evaluate the ex vivo cultivation potential of T.cruzi, L.tropica and T.gondii parasites in J774, Vero and HeLa cells and to reproduce in a short time and in large amounts without losing their virulence properties. Ex vivo experimental models were created by infecting J774, Vero and HeLa cell lines confluently produced in cell culture flasks with T.cruzi, L.tropica and T.gondii parasites. In ex vivo cultivation, one passage was applied for seven days and three times in a row. Cells removed from the surface after each passage were plated on eight-well chamber slides. Giemsa stained slides were prepared and infection rates were evaluated by light microscopic examination. At the end of the study, it was observed that all three cell lines could be infected with T.cruzi, L.tropica and T.gondii parasites, and infection rates increased in all cell lines after consecutive passages. As a result of ex vivo cultivation, the best cell lines from which T.cruzi and L.tropica strains grew, were J774, Vero and HeLa, and HeLa, J774 and Vero cell lines for T.gondii strain, respectively (p<0.05). Trypanosoma cruzi, L.tropica and T.gondii parasites were successfully grown in J774, Vero and HeLa cell lines by ex vivo culture method in a short time and in large amounts without losing their virulence properties. Cell lines with the best ex vivo cultivation potential for T.cruzi and L.tropica parasites were J774, Vero and HeLa, respectively, while HeLa, J774 and Vero for T.gondii. It is thought that the data obtained in this regard will contribute to many studies on the development of vaccines, drugs and new diagnostic kits.</p>","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 1","pages":"71-82"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10531353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Analysis of IFN-γR1 (CD119) and IL-12Rβ1 (CD212) Deficiency by Flow Cytometry].","authors":"Metin Yusuf Gelmez, Kaya Köksalan, Suzan Çınar, Nevin Hatipoğlu, Taner Coşkuner, Zeynep Topkarcı, Selda Hançerli Törün, Asuman Demirbuğa, Esra Yücel, Ayça Kıykım, Haluk Cezmi Çokuğraş, Hatice Betül Gemici-Karaaslan, Yasemin Kendir-Demirkol, Günnur Deniz","doi":"10.5578/mb.20239907","DOIUrl":"10.5578/mb.20239907","url":null,"abstract":"<p><p>Mendelian susceptibility to mycobacterial diseases (MSMD) is a rare primary immune deficiency (PID). IL-12Rβ1 deficiency is the most frequently observed of more than 16 genetic defects that have been identified for MSMD. Genetic and immunological tests are remarkable in the diagnosis of PID. In this study, it was aimed to determine the expression of IFN-γR1 and IL-12Rβ1 in patients with MSMD, their relatives, and healthy individuals and to evaluate the importance of flow cytometry as a fast and reliable method in the diagnosis of MSMD. IFN-γR1 and IL-12Rβ1 expression levels were analyzed in 32 volunteers including six patients, six relatives, and 20 healthy individuals. The normal range of IFN-γR1 and IL-12Rβ1 levels among healthy individuals were determined. IL-12Rβ1 expression level in lymphocytes was found to be low in one patient's relative, and less than 1% in three patients and in one patient's relative. It was observed that the IL-12Rβ1 expression levels of the patient with STAT1 deficiency were increased compared to the healthy individuals. No difference was found in the expression levels of IFN-γR1 and IL-12Rβ1 in one patient, but IFN-γR1 expression was decreased in one patient compared to healthy individuals. Our results show that the determination of IL-12Rβ1 and IFN-γR1 deficiencies by flow cytometry can be used as a rapid and reliable method for the diagnosis of MSMD. The use of this method as a screening test will enable early diagnosis especially in patients whose genetic diagnosis has not been confirmed and clinically compatible with MSMD. In addition, it is thought that IL-12Rβ1 and IFN-γR1 range data obtained from healthy individuals will be considered as a reference source in routine and research studies to be conducted with MSMD.</p>","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 1","pages":"83-96"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9098324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Duygu Dalğıç, Tülay Kandemir, Ali Üçkayabaşı, Toğrul Nağıyev
{"title":"[Relationship of Hypervirulent Capsular Genotypes of Klebsiella pneumoniae with Antibiotic Susceptibility and Beta-Lactamase Genes].","authors":"Duygu Dalğıç, Tülay Kandemir, Ali Üçkayabaşı, Toğrul Nağıyev","doi":"10.5578/mb.20239903","DOIUrl":"https://doi.org/10.5578/mb.20239903","url":null,"abstract":"<p><p>Klebsiella pneumoniae which is a causative agent of nosocomial infections, is protected from phagocytosis and the lethal effect of serum bactericidal proteins owing to its capsular polysaccharides (CPS). The important leading problem in treating infections caused by this bacterium that successfully develops antimicrobial resistance, especially via mobile genetic elements, is that it acquires beta-lactamase genes, which are responsible for the resistance against beta-lactam antibiotics. Due to the increase in studies targeting capsular polysaccharides in developing strategies for vaccination and treatment, we aimed to investigate the possible relationship of the capsular genotypes of K.pneumoniae isolates obtained from various clinical specimens with antibiotic susceptibility and beta-lactamase genes. In K.pneumoniae clinical isolates; K1, K2, K5, K20, K54 and K57, which are known as hypervirulent capsular types, were investigated by polymerase chain reaction (PCR) method. In isolates whose capsular genotypes were determined, antibiotic susceptibility was examined by Kirby-Bauer disc diffusion method. Colistin resistance was investigated by the broth microdilution method. Carbapenem resistance was confirmed with the carbapenem inactivation test. The beta-lactamase genes blaCTX-M1, blaCTX-M2, blaCTX-M9, blaCTX-M8/25, blaKPC, blaNDM-1, and blaOXA-48-like were investigated by using PCR. Of the 38 K.pneumoniae isolates whose capsular genotypes were determined, 15 (39.5%), 12 (31.6%), seven (18.4%), two (5.3%), one (2.6%) and one (2.6%) were K5-CPS, K2-CPS, K20-CPS, K1-CPS, K54-CPS and K57-CPS genotypes, respectively. blaOXA-48-like, blaNDM-1, and blaCTX-M1 were detected in 68.4, 10.5, and 7.9%, whereas coexistence of blaOXA-48-like with blaNDM-1, and blaOXA-48-like with blaCTX-M1 were determined in 7.9, and 5.3% of the isolates, respectively. The relationship of the blaCTX-M1 gene, detected only in three K20-CPS isolates, was found to be statistically significant with this genotype. In addition, of the blaNDM-1-positive four isolates, three were K5-CPS, and one was K2-CPS, while blaOXA-48-like was similarly detected mostly in K5-CPS and K2-CPS (10 and 9 isolates, respectively). Except for the two isolates that were resistant to colistin, one K1-CPS and the other K5-CPS, the highest resistance was detected against cefotaxime (36/38) and the lowest resistance was detected against gentamicin (23/38) as a result of antibiotic susceptibility tests. The resistance relationship of K5-CPS isolates with amoxicillin/clavulanate, piperacillin/tazobactam, cefoxitin and ertapenem and the susceptibility relationship of K20-CPs isolates with amoxicillin/clavulanate, piperacillin/tazobactam, imipenem, tetracycline and trimethoprim/sulfamethoxazole were found as statistically significant. Our study is the first to investigate the relationship between K.pneumoniae capsular genotypes and beta-lactamase genes in Turkey. As a result, it is believed that this researc","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 1","pages":"30-44"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9098323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[How to Defend Mandatory Immunization Against Vaccine Hesitancy and Vaccine Refusal? An Ethical Assessment].","authors":"M Murat Civaner","doi":"10.5578/mb.20239913","DOIUrl":"https://doi.org/10.5578/mb.20239913","url":null,"abstract":"<p><p>One of the basic ethical principles in medical practice is to respect personal autonomy. However, it is a widely accepted view that when it comes to health problems that concern not only the individual but also the society, especially in epidemics of infectious diseases, individual autonomy can be violated by prioritizing the benefit of the community. This view is based on the scientific fact that epidemics can only be controlled by immunizing all susceptible individuals. However, whether all susceptible individuals can be compelled to be immunized remains a matter of debate around the world. Especially in the last three years, during the worldwide Coronavirus disease-2019 (COVID-19) pandemic, a significant part of the society has been hesitant about being vaccinated, and some have argued that vaccines should be rejected altogether. In the face of the situation outlined above, the question of \"should immunization be mandatory?\" has become more important than ever to be able to answer the question in a way that will ensure as broad consensus as possible. In this review article; it was discussed under which conditions mandatory immunization could be justified in terms of ethics and thus, it was aimed to contribute to the solution of the vital problem created by the phenomenon of vaccine hesitancy and rejection in terms of public health. To this aim, first of all, the need to clarify some concepts was mentioned. Afterwards, the arguments \"must be compulsory\", \"should be optional\", and \"should not be done to anyone\" were evaluated with their justifications and it was determined that the argument that immunization should be mandatory could be justified in terms of ethics. In the article, it was argued that the conflicts of \"individual freedom X community benefit\" and \"personal autonomy X community benefit\" did not exist in today's actual conditions, but it was stated that an individual with the knowledge of reality experiences a tension in the face of not putting this knowledge into practice. It was emphasized that in order to overcome this tension, consolidation of the theoretical background and also consideration of the macro determinants of vaccine hesitancy and rejection in practice were necessary. What needs to be done to re-establish trust in the medical institution was listed, and it was argued that the question of how to implement mandatory immunization could only be answered in a healthy way through a transformation process that will be implemented through a social dialogue.</p>","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 1","pages":"156-170"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9094877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Okan Derin, Esin Nagihan Öztürk, Nazife Duygu Demirbaş, Dilek Yıldız Sevgi, İlyas Dökmetaş
{"title":"[A Patient Presented with Genital Eruptions: The Second Case of Monkeypox from Türkiye].","authors":"Okan Derin, Esin Nagihan Öztürk, Nazife Duygu Demirbaş, Dilek Yıldız Sevgi, İlyas Dökmetaş","doi":"10.5578/mb.20239911","DOIUrl":"10.5578/mb.20239911","url":null,"abstract":"<p><p>Human monkeypox (MPX) disease is a re-emerging zoonotic infection caused by the monkeypox virus belonging to the same family as vaccinia and variola. The European Center for Disease Prevention and Control (ECDC) has documented an outbreak of MPX with atypical transmission paths throughout Europe. In this report, male-to-male sexual intercourse was first defined as a means of close humanto-human contact. The Ministry of Health of the Republic of Turkey announced via social media on June 30, 2022 that the first case confirmed by polymerase chain reaction (PCR) for the MPX virus in Turkey was admitted and isolated in a hospital. Four days after this statement, a 24-year-old Turkish man was hospitalized in our clinic with a bacterial infection of the penis and scrotum following local radiofrequency ablation therapy. A week ago, lesions resembling warts were noted in his medical history, for which a local radiofrequency ablation procedure was conducted at an external center. One day after his hospitalization, skin lesions of different stages (from macules, papules to umbilical papules) and several eruptions were detected on his face, nose tip, body, arms, and fingers, which gradually became more evident. After evaluating the risk factors, the patient was isolated with a preliminary diagnosis of MPX disease and samples were collected and sent for MPX virus detection to the reference laboratory according to the Ministry of Health guidelines. MPX virus nucleic acid was detected by PCR in samples taken from the lesion. The patient was discharged after 21 days of isolation and treatment for a secondary bacterial infection. In this case report the significance of differential diagnosis and screening tests for sexually transmitted infections (STI), a previously unreported case of MPX disease in Turkey, and a soft tissue infection that developed after local ablation treatment which was administered to a patient with MPX disease were presented. To be prepared for new and re-emerging infectious diseases, it was emphasized that well-structured continuing education based on current epidemiological data is required. Sexual contact has recently been identified as a new mode of transmission for MPX disease, and symptoms and signs may resemble those of other ulcerative sexually transmitted infections (STIs), such as \"molluscum contagiousum\" or syphilis. ORF disease is also in the differential diagnosis of MPX disease in Turkey. In addition, patients admitted with unreported STIs are permitted to receive health services without additional screenings. For this reason, easily accessible sexually transmitted disease centers with a high diagnostic efficiency can provide greater control over these diseases.</p>","PeriodicalId":18509,"journal":{"name":"Mikrobiyoloji bulteni","volume":"57 1","pages":"134-140"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9094880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}